Evidence map›Paper›PMID 27299450›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016

Local infiltration analgesia adds no clinical benefit in pain control to peripheral nerve blocks after total knee arthroplasty.

Pedro Hinarejos, Bruno Capurro, Xavier Santiveri, Pere Ortiz, Joan Leal, Xavier Pelfort, Raul Torres-Claramunt, Juan Sánchez-Soler, Joan C Monllau

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. [Progress of injection sites of local infiltration analgesia in total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023
    Review
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

9 authors at 2 institutions in 1 country.

Pedro HinarejosOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain. phinarejos@parcdesalutmar.cat.
Bruno CapurroOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain.
Xavier SantiveriAnesthesiology Department, Parc de Salut Mar, Barcelona, Spain.
Pere OrtizPharmacy Department, Parc de Salut Mar, Barcelona, Spain.
Joan LealOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain.
Xavier PelfortConsorci Sanitari de l'Anoia - Hospital d'Igualada, Barcelona, Spain.
Raul Torres-ClaramuntOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain.
Juan Sánchez-SolerOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain.
Joan C MonllauOrthopedic Surgery Department, Parc de Salut Mar, Universitat Autònoma de, 08024, Barcelona, Spain.
Parc de Salut · ESHospital d'Igualada · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the effect of the local infiltration of analgesics for pain after total knee arthroplasty in patients treated with femoral and sciatic peripheral nerve blocks. The secondary objective was to detect differences in analgesic consumption as well as blood loss after local infiltration of analgesics.

methodsProspective randomized double-blinded study in patients who underwent a TKA for knee osteoarthritis under spinal anesthesia and treated with femoral and sciatic nerve blocks. This study compared 50 patients treated with local infiltration with ropivacaine, epinephrine, ketorolac and clonidine and 50 patients treated with a placebo with the same technique. The visual analogic score was registered postoperatively at 2, 6, 12, 24, 36, 48 and 72 h after surgery. Analgesic consumption was also registered. Both groups of patients were treated with the same surgical and rehabilitation protocols.

resultsA significant difference of one point was found in the visual analogic pain scores 12 h after surgery (0.6 ± 1.5 vs. 1.7 ± 2.3). There were no significant differences in the visual analogic pain scores evaluated at any other time between 2 and 72 h after surgery. No significant differences were found in the required doses of tramadol or morphine in the postoperative period. Postoperative hemoglobin and blood loss were also similar in both groups.

conclusionAdding local infiltration of analgesics to peripheral nerve blocks after TKA surgery only provides minimal benefit for pain control. This benefit may be considered as non-clinically relevant. Moreover, the need for additional analgesics was the same in both groups. Therefore, the use of local infiltration of analgesics treatment in TKA surgery cannot be recommended if peripheral nerve blocks are used. LEVEL OF EVIDENCE: I.

Indexed as

Nerve BlockAdultAgedAged, 80 and overAnalgesiaAnalgesics, OpioidAnesthetics, LocalArthroplasty, Replacement, KneeDouble-Blind MethodHumansMiddle AgedMorphinePain ManagementPain MeasurementPeripheral NervesPostoperative PainAnalgesics, OpioidAnesthetics, LocalMorphineTramadolLocal infiltration of analgesicsPain controlPeripheral nerve blocksTotal knee arthroplasty

Identifiers

PMID27299450
OpenAlexW2427384699

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.