Compared with a continuous femoral nerve block, a continuous adductor canal block did not appreciably decrease the time to overall discharge readiness even though it did decrease the time until adequate mobilization, primarily because both groups experienced similar analgesia and intravenous opioid requirements that--in most cases--exceeded the time to mobilization.

The results of this study do not support adding an ambulatory, continuous ropivacaine infusion to a single-injection ropivacaine TAP block for hernia surgery. However, the present investigation was underpowered, and further study is warranted.

No evidence was found to support the hypothesis that changing the local anesthetic administration technique (continuous basal versus hourly bolus) when using an adductor canal perineural catheter at 8 mL/h decreases cutaneous sensation in the distribution of the anterior branch of the medial femoral cutaneous nerve.

Compared with a continuous femoral nerve block, a continuous adductor canal block did not appreciably decrease the median number of hours to overall discharge readiness, yet did decrease the number of discrete days until discharge readiness. These results are applicable to only unicompartment knee arthroplasty and must be considered preliminary because of the limited sample size of this pilot study.

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T here is evidence that use of a paravertebral block (PVB) during surgery may reduce risk of postoperative nausea and provide superior acute pain control in surgeries compared with general anesthesia/systematic analgesia (GA/SA). However, recent surveys show that anesthesiologists still favor the latter. Thus, the authors of the current review hypothesized that PVB for inguinal herniorrhaphy surgery was noninferior in postoperative pain outcomes to GA/SA, neuraxial pain blocks, and other peripheral nerve blocks. They also hypothesized that superiority scores on all outcomes were 1 or greater.The authors complied with the Transparent Reporting of Systematic Reviews and Meta-Analyses (PRISMA) statement and searched multiple databases for randomized controlled trials (no greater than 3 years) on PVB. Search terms included "paravertebral block AND inguinal AND (herniorrhaphy OR hernia)." After data were extracted, patient pain score outcomes were converted to a numeric visual analog scale (0-10) and categorized into intervals of 0 to 6, 6 to 24, and 24 to 72 hours postoperatively. A range of secondary outcomes were examined, including but not limited to nausea and vomiting, urine retention, and postanesthesia care unit (PACU) bypass rate.A total of 14 studies were included and compared in subsets (4 compared PVB with GA/SA, 6 compared PVB with neuraxial blocks, and 4 compared PVB with other peripheral nerve blocks). For studies comparing PVB with GA/SA and neuraxial blocks, no differences in postoperative pain scores were found for all time points. However, these results had wide 95% confidence intervals, implying that the null hypothesis on noninferiority on outcomes could not be rejected (quality of evidence [QoE], low; publication bias and imprecision). For PVB versus other peripheral nerve blocks, 1 study reported that PVB had better pain control than iliohypogastric nerve block from 9 to 48 hours, and another reported better pain control than transversus abdominis plane block up to 12 hours postoperatively. PVB patients used fewer analgesics postoperatively than other peripheral nerve block patients. For secondary outcomes, compared with GA/SA patients, PVB patients had less postoperative nausea and vomiting (nausea: risk ratio [RR], 0.22; vomiting: RR, 0.15; QoE, high; publication bias and large effect) and bypassed the PACU more frequently (79.6% vs 13%; QoE, high). Compared with neuraxial block patients, PVB patients

No abstract