SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2017
Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Comparison Efficacy of Analgesic Techniques: Continuous Epidural Analgesia Versus Bilateral Single-shot Adductor Canal Blocks in Patients Undergoing Bilateral Total Knee Arthroplasty
Impact of Integrated Care Pathways for Prevention of Post-operative Urinary Retention in Primary Total Knee or Total Hip Replacement: Prospective Randomized Control Trial
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- The role of sciatic nerve block to complement femoral nerve block in total knee arthroplasty: a meta-analysis of randomized controlled trials.Journal of anesthesia · 2018Pooled it
- Observation and Analysis of the Postoperative Analgesic Effect of Subanaesthetic Dose of Ketamine in Kashin-Beck Disease Patients after Total Knee Arthroplasty.Journal of healthcare engineering · 2022Trial
- Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques.Journal of musculoskeletal & neuronal interactions · 2021Trial
- Trial
- Continuous adductor canal block following total knee arthroplasty provides a better analgesia compared to single shot: A prospective randomized controlled trial.Acta orthopaedica et traumatologica turcica · 2019Trial
- Success rate and efficacy of intentional ipsilateral epidural catheter placement for anterior cruciate ligament reconstruction surgery: a retrospective analysis of 307 consecutive patients.Journal of anesthesia · 2026Article
- Peripheral Nerve Blocks in Patients With Osteogenesis Imperfecta Undergoing Extremity Procedures are Safe and Effective.Journal of the Pediatric Orthopaedic Society of North America · 2025Article
- Perioperative neurocognitive disorders: A narrative review focusing on diagnosis, prevention, and treatment.CNS neuroscience & therapeutics · 2022Review
- Epidural anesthesia in dogs undergoing hindlimb orthopedic surgery: effects of two injection sites.The Journal of veterinary medical science · 2022Article
- A guide to regional analgesia for Total Knee Arthroplasty.EFORT open reviews · 2021Article
- Intrapartum pudendal nerve block analgesia and risk of postpartum urinary retention: a cohort study.International urogynecology journal · 2021Article
- A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty.The Korean journal of pain · 2021Article
- Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report.JA clinical reports · 2019Article
- The geriatric patient: special aspects of peri-operative management.EFORT open reviews · 2019Review
- The history of microsurgery.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Review
- Regional and Multimodal Analgesia to Reduce Opioid Use After Total Joint Arthroplasty: A Narrative Review.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2019Review
- [Regional anesthesia: tradition and innovation].Der Anaesthesist · 2017Article
- Successful use of femoral nerve block with dexmedetomidine for fracture fixation of an intracapsular fracture of the femoral neck in a patient with severe aortic stenosis: a case report.JA clinical reports · 2017Article
- Adductor canal blockade versus continuous epidural analgesia after total knee joint replacement: A retrospective cohort study.Saudi journal of anaesthesiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR.
methodsWe conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL). We applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators, and limits in each of the above databases. Pain intensity assessed on visual analogue scale (VAS), nausea and vomiting, systolic hypotension, and urinary retention was the reported outcome parameters.
resultsWe identified 12 randomised controlled trials (RCTs) comparing outcomes of epidural analgesia and PNB reporting a total of 670 patients. There was no significant difference between two groups in VAS scores at 0-12 h (MD -0.48; 95 % CI -1.07-0.11, P = 0.11), 12-24 h (MD 0.04; 95 % CI -0.81-0.88, P = 0.93), and 24-48 h (MD 0.16; 95 % CI -0.08-0.40, P = 0.19). However, epidural analgesia was associated with significantly higher risk of postoperative nausea and vomiting (RR 1.65; 95 % CI, 1.20-2.28, P = 0.002), hypotension (RR 1.76; 95 % CI, 1.26-2.45, P = 0.0009), and urinary retention (RR 4.51; 95 % CI, 2.27-8.96, P < 0.0001) compared to PNB. Moreover, pooled analysis of data from 6 RCTs demonstrated no significant difference in VAS score between ACB and FNB at 24 h (MD -0.00; 95 % CI, -0.56-0.56, P = 0.99) and 48 h (MD -0.06; 95 % CI, -0.14-0.03, P = 0.23).
conclusionsPNB is as effective as epidural analgesia for postoperative pain management in patients undergoing TKR. Moreover, it is associated with significantly lower postoperative complications. ACB appears to be an effective PNB with similar analgesic effect to FNB after TKR. Future RCTs may provide better evidence regarding knee range of motion, length of hospital stay, and neurological complications.
Indexed as
Identifiers
What OpenQuestion holds
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.