A meta-analysis of countious femoral nerve block versus continuous epidural analgesia after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2015.35.028

Abstract

Abstract:

BACKGROUND: Pain is the significant cause for patients with early rehabilitation after total knee arthroplasty. Continuous epidural analgesia and continuous femoral nerve block are effective analgesic methods after total knee arthroplasty, however, which method has better effects and less complications remains controversial.
OBJECTIVE: To compare the efficacy and safety of countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty.
METHODS: We searched Cochrane Library, PubMed, EMBASE, Web of Science, CBM, CNKI, VIP, and WangFang. Meanwhile, we also searched conference papers and academic dissertation. The retrieval time was from database establishment to October 1, 2014. Studies of randomized controlled trials on countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty were included. We evaluated the quality of these included studies and analyzed data by Cochrane Collaboration’s RevMan 5.0 software.
RESULTS AND CONCLUSION: A total of 12 randomized controlled trials (4 English articles and 8 Chinese articles) involving 680 patients were included. There were 343 patients with countious femoral nerve block and 337 patients with continuous epidural analgesia. Meta-analysis results revealed that no significant differences in visual analog scale scores were detected between the countious femoral nerve block and continuous epidural analgesia groups at 6, 12, 24 and 48 hours after total knee arthroplasty. However, compared with the continuous epidural analgesia group, countious femoral nerve block could decrease the incidences of nausea/vomiting (RR=0.36, 95% CI: 0.21-0.63, P=0.003), urine retention (RR=0.08, 95% CI: 0.04-0.16, P < 0.001) and dizziness (RR=0.24, 95% CI: 0.06-0.99, P=0.05). These results indicate that compared with epidural analgesia, countious femoral nerve block after total knee arthroplasty provided a strong analgesia effect, contributed to early functional training, had less adverse reactions, and was a safe and effective analgesic method.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Analgesia, Femoral Nerve, Analgesia, Epidural, Meta-Analysis

CLC Number:

R318

Yuan Zhi-min, Wei Jian-tong, Wen Jing-rong, Yang Sen, Quan Dong-he. A meta-analysis of countious femoral nerve block versus continuous epidural analgesia after total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5728-5734.

Figures/Tables 9

References

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