Value of Single-Injection or Continuous Sciatic Nerve Block in Addition to a Continuous Femoral Nerve Block in Patients Undergoing Total Knee Arthroplasty

Wegener, Jessica; Ooij, Bas van; Dijk, C. Niek van; Hollmann, Markus W.; Preckel, Benedikt; Stevens, Markus F.

doi:10.1097/aap.0b013e318228c33a

Cited by 92 publications

(75 citation statements)

References 33 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1), eight of which were published between January 1998 and March 2015 and met the eligibility criteria. 16,19,21,28,[38][39][40][41] One published abstract 17 was excluded for lack of outcome results after contacting its authors. Five trials that compared SNB with various analgesic modalities, but lacked an appropriate FNB control group, were also excluded.…”

Section: Resultsmentioning

confidence: 99%

“…We subsequently evaluated the contribution of these characteristics to the heterogeneity of the results using subgroup analysis. Because evidence suggests that continuous SNB (i.e., catheter-based infusion via a pump) prolongs the duration of SNB analgesia, 16 we hypothesized that catheter use would introduce significant heterogeneity into our results. Consequently, we planned to analyze the outcome data separately according to whether single-shot sciatic nerve block (SSNB) or continuous sciatic nerve block (CSNB) had been used.…”

Section: Definition Of Relevant Outcome Datamentioning

confidence: 99%

“…14 Recently, however, nine RCTs have been separately published, with seemingly mixed results. [15][16][17][18][19][20][21][22][23] In this updated meta-analysis, we aimed to quantify the analgesic effects of adding proximal single-shot or continuous SNB to single-shot or continuous FNB in the absence of LIA on analgesic consumption and pain scores during the first 48 hr postoperatively in adult patients undergoing unilateral TKA.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Abdallah

Madjdpour

Brull

2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Section: Definition Of Relevant Outcome Datamentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Abdallah

Madjdpour

Brull

2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…Additionally, numerous studies have compared the efficacy of various types of neuraxial anesthetics and peripheral blocks [1,7,23,28,31,37,38]. The addition of a sciatic block to a femoral block provides better pain relief than femoral block alone, and various combinations have been studied [4,7,10,17,37]. However, we were unable to find any study directly comparing this commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection.…”

Section: Introductionmentioning

confidence: 99%

“…Many authors have shown that periarticular injections provide improved pain relief compared with no injection [6,22,36]. Additionally, numerous studies have compared the efficacy of various types of neuraxial anesthetics and peripheral blocks [1,7,23,28,31,37,38]. The addition of a sciatic block to a femoral block provides better pain relief than femoral block alone, and various combinations have been studied [4,7,10,17,37].…”

Section: Introductionmentioning

confidence: 99%

The Chitranjan Ranawat Award: Periarticular Injections and Femoral & Sciatic Blocks Provide Similar Pain Relief After TKA: A Randomized Clinical Trial

Spangehl

Clarke

Hentz

et al. 2015

Clinical Orthopaedics &Amp; Related Research

128

View full text Add to dashboard Cite

Background Two of the more common methods of pain management after TKA are peripheral nerve blocks and intraarticular/periarticular injections. However, we are not aware of any study directly comparing the commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection after TKA. Questions/purposes This randomized clinical trial compared a combined femoral and sciatic nerve block with periarticular injection as part of a multimodal pain protocol after total knee arthroplasty with respect to (1) pain; (2) narcotic use; (3) quadriceps function and length of stay; and (4) peripheral nerve complications. Methods One hundred sixty patients completed randomization into two treatment arms: (1) peripheral nerve blocks (PNB; n = 79) with an indwelling femoral nerve catheter and a single shot sciatic block; or (2) periarticular injection (PAI; n = 81) using ropivacaine, epinephrine, ketorolac, and morphine. All patients received standardized general anesthesia and oral medications. The primary outcome was postoperative pain, on a 0 to 10 scale, measured on the afternoon of postoperative day 1 (POD 1). Secondary outcomes were narcotic use, quadriceps function, length of stay, and peripheral nerve complications. Results Mean pain scores on the afternoon of POD 1 were not different between groups (PNB group: 2.9 [SD 2.4]; PAI group: 3.0 [SD 2.2]; 95% confidence interval, À0.8 to 0.6; p = 0.76). Mean pain scores taken at three times points on POD 1 were also similar between groups. Hospital length of stay was shorter for the PAI group (2.44 days [SD 0.65] versus 2.84 days [SD 1.34] for the PNB group; p = 0.02). Narcotic consumption was higher the day of surgery for the PAI group (PAI group: 11.7 mg morphine equivalents [SD 13

show abstract

Femoral nerve blocks for acute postoperative pain after knee replacement surgery

Chan

Fransen

Parker

et al. 2014

Cochrane Database of Systematic Reviews

164

112

View full text Add to dashboard Cite

Background Total knee replacement (TKR) is a common and o en painful operation. Femoral nerve block (FNB) is frequently used for postoperative analgesia. Objectives To evaluate the benefits and risks of FNB used as a postoperative analgesic technique relative to other analgesic techniques among adults undergoing TKR. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2013, Issue 1, MEDLINE, EMBASE, CINAHL, Web of Science, dissertation abstracts and reference lists of included studies. The date of the last search was 31 January 2013. Selection criteria We included randomized controlled trials (RCTs) comparing FNB with no FNB (intravenous patient-controlled analgesia (PCA) opioid, epidural analgesia, local infiltration analgesia, and oral analgesia) in adults a er TKR. We also included RCTs that compared continuous versus single-shot FNB. Data collection and analysis Two review authors independently performed study selection and data extraction. We undertook meta-analysis (random-e ects model) and used relative risk ratios (RRs) for dichotomous outcomes and mean di erences (MDs) or standardized mean di erences (SMDs) for continuous outcomes. We interpreted SMDs according to rule of thumb where 0.2 or smaller represents a small e ect, 0.5 a moderate e ect and 0.8 or larger, a large e ect. Main results We included 45 eligible RCTs (2710 participants) from 47 publications; 20 RCTs had more than two allocation groups. A total of 29 RCTs compared FNB (with or without concurrent treatments including PCA opioid) versus PCA opioid, 10 RCTs compared FNB versus epidural, five RCTs compared FNB versus local infiltration analgesia, one RCT compared FNB versus oral analgesia and four RCTs compared continuous versus single-shot FNB. Most included RCTs were rated as low or unclear risk of bias for the aspects rated in the risk of bias Femoral nerve blocks for acute postoperative pain a er knee replacement surgery (Review)

show abstract

Value of Single-Injection or Continuous Sciatic Nerve Block in Addition to a Continuous Femoral Nerve Block in Patients Undergoing Total Knee Arthroplasty

Cited by 92 publications

References 33 publications

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

The Chitranjan Ranawat Award: Periarticular Injections and Femoral & Sciatic Blocks Provide Similar Pain Relief After TKA: A Randomized Clinical Trial

Femoral nerve blocks for acute postoperative pain after knee replacement surgery

Contact Info

Product

Resources

About