Evidence map›Paper›PMID 21561303›Full record

Trial reportActa orthopaedica2011

Pain control after total knee arthroplasty: a randomized trial comparing local infiltration anesthesia and continuous femoral block.

Fatin Affas, Eva-Britt Nygårds, Carl-Olav Stiller, Per Wretenberg, Christina Olofsson

3 registry-linked trialsAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Acta orthopaedica, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 55 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03025594 phase3unknown statusnot on this mapstarted 2017, after this paper: background citation

Gonyautoxins Local Periarticular Injection for Pain Management After Total Knee Arthroplasty: A Double Blind Randomized Study

TypeinterventionalSponsormaximiliano barahona vasquezRan2017 to 2017Enrolled64ConditionsKnee Arthroplasty, Pain ManagementArmsGonyautoxins, Chirocaine ketorolac epinephrine
NCT04086186 phase4completednot on this mapstarted 2017, after this paper: background citation

Clinical Outcomes of an Adductor Canal Block Versus Liposomal Bupivacaine in Total Knee Arthroplasty Patients: A Randomized Prospective Study

TypeinterventionalSponsorGood Samaritan Regional Medical Center, OregonRan2017 to 2018Enrolled60ConditionsTotal Knee Arthroplasty, Post-operative Pain ControlArmsLiposomal Bupivacaine Peri-articular Injection, Adductor canal block
NCT04414995 phase2 / phase3completednot on this mapstarted 2020, after this paper: background citation

Effect of Paracetamol and Ibuprofen When Intravenously Given Combination or Alone in Reducing Morphine Requirements After Total Knee Arthroplasty

TypeinterventionalSponsorIndonesia UniversityRan2020 to 2020Enrolled36ConditionsAnalgesiaArmsParacetamol injection and Ibuprofen injection, Paracetamol injection and normal saline, Ibuprofen Injection and normal saline
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  14. No advantage of adrenaline in the local infiltration analgesia mixture during total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
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  18. Local infiltration analgesia adds no clinical benefit in pain control to peripheral nerve blocks after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Fatin AffasDepartment of Anesthesiology and Intensive Care, Section of Orthopaedics, Karolinska Institute and Karolinska University Hospital, Solna, Sweden.
Eva-Britt Nygårds
Carl-Olav Stiller
Per Wretenberg
Christina Olofsson

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposePain after total knee arthroplasty (TKA) is usually severe, and epidural analgesia or femoral nerve block has been considered to be an effective pain treatment. Recently, local infiltration analgesia (LIA) has become increasingly popular but the outcome of this method regarding the analgesic effect has not been fully evaluated. We compared local infiltration analgesia and femoral block with regard to analgesia and morphine demand during the first 24 h after TKA.

methods40 patients undergoing TKA under spinal anesthesia were randomized to receive femoral nerve block (group F) or peri- and intraarticular infiltration analgesia (group LIA) with a mixture containing ropivacaine, ketorolac, and epinephrine. All patients had access to intravenous patient-controlled analgesia (PCA) with morphine postoperatively. Pain intensity at rest and upon movement was assessed on a numeric rating scale (0-10) on an hourly basis over 24 h if the patients were awake.

resultsThe average pain at rest was marginally lower with LIA (1.6) than with femoral block (2.2). Total morphine consumption per kg was similar between the 2 groups. Ancillary analysis revealed that 1 of 20 patients in the LIA group reported a pain intensity of > 7 upon movement, as compared to 7 out of 19 in the femoral block group (p = 0.04).

interpretationBoth LIA and femoral block provide good analgesia after TKA. LIA may be considered to be superior to femoral block since it is cheaper and easier to perform.

Indexed as

Anesthesia, LocalArthroplasty, Replacement, KneeNerve BlockAdultAgedAged, 80 and overAmidesAnalgesiaAnesthetics, LocalCyclooxygenase InhibitorsEpinephrineFemaleFemoral NerveHumansKetorolacMaleAmidesAnesthetics, LocalCyclooxygenase InhibitorsEpinephrineKetorolacRopivacaine

Identifiers

PMID21561303
PMCPMC3237035

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.