Evidence map›Paper›PMID 23440367›Full record

SynthesisBritish journal of anaesthesia2013

Falls and major orthopaedic surgery with peripheral nerve blockade: a systematic review and meta-analysis.

R L Johnson, S L Kopp, J R Hebl, P J Erwin, C B Mantilla

4 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 54 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 11 pooled it
18.9field-weighted citation impact, top 1% of its field
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.

NCT02584452 nacompletednot on this mapstarted 2015, after this paper: background citation

Randomized Controlled Trial Evaluating Postoperative Analgesia and Muscle Strength Between Single Versus Continuous Adductor Canal Block for Ambulatory ACL Reconstruction.

TypeinterventionalSponsorVanderbilt University Medical CenterRan2015 to 2018Enrolled59ConditionsRupture of Anterior Cruciate Ligament, Tear of Anterior Cruciate LigamentArmsMepivacaine, adductor canal continuous nerve catheter, Normal Saline as bolus followed by bupivacaine, adductor canal nerve block, ropivacaine and dexamethasone
NCT02909257 phase4terminatednot on this mapstarted 2016, after this paper: background citation

Minimum Effective Concentration of Bupivacaine for Motor-Sparing Femoral Nerve Block

TypeinterventionalSponsorUniversity of ChileRan2016 to 2017Enrolled31ConditionsOsteoarthritis, Knee, Knee InjuriesArmsSame Bupivacaine Concentration, Lower Bupivacaine Concentration
NCT03303794 phase3terminatednot on this mapstarted 2017, after this paper: background citation

Comparative Feasibility and Efficacy of a Five Compartment Technique Using 0.25% Bupivacaine vs a Mixture of 0.25% Bupivacaine and 1.3 % Liposomal Bupivacaine in Patients Undergoing Tka; a Single Blinded Randomized Controlled Study

TypeinterventionalSponsorMontefiore Medical CenterRan2017 to 2018Enrolled25ConditionsAnesthesiaArmsExparel, 0.25% bupivacaine
NCT03944005 nawithdrawnnot on this mapstarted 2020, after this paper: background citation

A Randomized Controlled Double Blinded Multicentre Study Comparing Discharge Readiness of Combined Adductor Canal and IPACK Blocks to LIA for Knee Arthroplasty Surgery.

TypeinterventionalSponsorWestern University, CanadaRan2020 to 2024Enrolled0ConditionsKnee ArthroplastyArmsSpinal Anesthesia + ACB continious catheter + iPACK + Sham LIA, Spinal Anesthesia + LIA + Sham Blocks
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 11 syntheses or guidelines pooled it, 155 citations in OpenAlex.

  1. Pooled it
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  6. Peripheral nerve blocks for hip fractures.The Cochrane database of systematic reviews · 2017
    Pooled it
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  20. 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
    Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

R L JohnsonDepartment of Anesthesiology, College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA. johnson.rebecca1@mayo.edu
S L Kopp
J R Hebl
P J Erwin
C B Mantilla
Mayo Clinic · US

Funding

Mayo Clinic Center for Translational Science ActivitiesUL1TR000135 · NCATS · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 2012 to 2015
$41.2M
NCATS NIH HHS UL1 TR000135
6 · The paper itself

Abstract

The objective of this systematic review with meta-analysis was to determine the risk for falls after major orthopaedic surgery with peripheral nerve blockade. Electronic databases from inception through January 2012 were searched. Eligible studies evaluated falls after peripheral nerve blockade in adult patients undergoing major lower extremity orthopaedic surgery. Independent reviewers working in duplicate extracted study characteristics, validity, and outcomes data. The Peto odds ratio (OR) with 95% confidence intervals (CIs) were estimated from each study that compared continuous lumbar plexus blockade with non-continuous blockade or no blockade using a fixed effects model. Ten studies (4014 patients) evaluated the number of falls as an outcome. Five studies did not contain comparison groups. The meta-analysis of five studies [four randomized controlled trials (RCTs) and one cohort] compared continuous lumbar plexus blockade (631 patients) with non-continuous blockade or no blockade (964 patients). Fourteen falls occurred in the continuous lumbar plexus block group when compared with five falls within the non-continuous block or no block group (attributable risk 1.7%; number needed to harm 59). Continuous lumbar plexus blockade was associated with a statistically significant increase in the risk for falls [Peto OR 3.85; 95% CI (1.52, 9.72); P=0.005; I(2)=0%]. Evidence was low (cohort) to high (RCTs) quality. Continuous lumbar plexus blockade in adult patients undergoing major lower extremity orthopaedic surgery increases the risk for postoperative falls compared with non-continuous blockade or no blockade. However, attributable risk was not outside the expected probability of postoperative falls after orthopaedic surgery.

Indexed as

Orthopedic ProceduresPeripheral NervesAccidental FallsAgedArthroplasty, Replacement, HipArthroplasty, Replacement, KneeClinical ProtocolsCohort StudiesData CollectionFemaleHumansLower ExtremityLumbosacral PlexusMaleMiddle AgedNerve Block

Identifiers

PMID23440367
PMCPMC3600943
OpenAlexW2158985128

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.