Systemic evaluation of femoral nerve block analgesia and patient controlled intravenous analgesia in pain control after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2013.17.005

Abstract

Abstract:

BACKGROUND: There is controversial on perioperative analgesic options of total knee arthroplasty.
OBJECTIVE: To assess the efficacy and safety of femoral nerve block analgesia and patient controlled intravenous analgesia in total knee arthroplasty.
METHODS: Randomized controlled trials on the application of femoral nerve block analgesia and patient controlled intravenous analgesia in total knee arthroplasty, and the literatures that met the evaluation criteria were included according to the inclusion and exclusion criteria in order to extract the required research data. The Meta-analysis was performed with RevMan 5.0.18 software. The evaluation indicators included the visual analog scale during postoperative 24 hours, 48 hours resting and activities period, the incidence rate of nausea, vomiting and gastrointestinal symptoms, as well as the incidence rate of lethargy and other excessive sedation and the satisfaction rate.
RESULTS AND CONCLUSION: Nineteen randomized controlled trials with 952 knees were included. There were 481 knees in the femoral nerve block analgesia group and 471 knees in the patient controlled intravenous analgesia group. After weighted Meta-analysis, the visual analog scale during postoperative 24 hours and 48 hours resting and activities period in the femoral nerve block analgesia group was lower than that in the patient controlled intravenous analgesia group (P < 0.05). There were significant differences in single femoral nerve block and continuous femoral nerve block. For the incidence of complications, the incidence rate of nausea, vomiting and gastrointestinal symptoms in the femoral nerve block analgesia group were lower than those in the patient controlled intravenous analgesia group (P < 0.05). Femoral nerve block analgesia was superior to patient controlled intravenous analgesia in postoperative analgesia and incidence of complications for patient having total knee arthroplasty, and the femoral nerve block analgesia has higher satisfaction. However, large-scale multi-center randomized controlled trials are required to evaluate the difference between femoral nerve block analgesia and patient controlled intravenous analgesia.

Key words: bone and joint implants, artificial prosthesis, total knee arthroplasty, analgesia, femoral nerve block, patient controlled intravenous analgesia, visual analog scale score, complications, Meta-analysis

CLC Number:

R318

Zhang Qi-dong, Liu Zhao-hui, Cheng Li-ming, Cao San-li, Xu Guang-chun, Lu Yu-feng, . Systemic evaluation of femoral nerve block analgesia and patient controlled intravenous analgesia in pain control after total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(17): 3073-3080.

Figures/Tables 9

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