Evidence map›Paper›PMID 28178436›Full record

ArticleRambam Maimonides medical journal2017

Femoral versus Multiple Nerve Blocks for Analgesia after Total Knee Arthroplasty.

Anatoli Stav, Leonid Reytman, Roger Sevi, Michael Yohay Stav, Devorah Powell, Yanai Dor, Mickey Dudkiewicz, Fuaz Bayadse, Ahud Sternberg, Michael Soudry

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Rambam Maimonides medical journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01303120 (Does a Single Shot Femoral Nerve Block Alone Produce Appropriate Pain Relief After Total Knee Arthroplasty or Should an Addition of Sciatic, Obturator and Lateral Femoral Cutaneous Nerve Blocks be Recommended?), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

NCT01303120 nacompletednot on this map

Does a Single Shot Femoral Nerve Block Alone Produce Appropriate Pain Relief After Total Knee Arthroplasty or Should an Addition of Sciatic, Obturator and Lateral Femoral Cutaneous Nerve Blocks be Recommended?

TypeinterventionalSponsorHillel Yaffe Medical CenterRan2011 to 2013Enrolled107ConditionsPost-operative PainArmsFemoral Nerve Block, Combined nerve blocks, Patient-controlled analgesia
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. A Unique Publication Model that Works.Rambam Maimonides medical journal · 2018
    Article
  3. Article
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

10 authors.

Anatoli StavPostanesthesia Care Unit, Hillel Yaffe Medical Center, Hadera, Israel.
Leonid ReytmanThe Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Roger SeviDepartment of Orthopedics A, Hillel Yaffe Medical Center, Hadera, Israel.
Michael Yohay StavThe Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Devorah PowellDepartment of Orthopedics A, Hillel Yaffe Medical Center, Hadera, Israel.
Yanai DorDepartment of Orthopedics A, Hillel Yaffe Medical Center, Hadera, Israel.
Mickey DudkiewiczThe Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Fuaz BayadsePostanesthesia Care Unit, Hillel Yaffe Medical Center, Hadera, Israel.
Ahud SternbergThe Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Michael SoudryDepartment of Orthopedics A, Hillel Yaffe Medical Center, Hadera, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypothesized that preoperative blocking of all four nerves would offer superior analgesia to femoral nerve block alone.

methodsThis is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 107 patients were randomly assigned to one of three groups: a femoral nerve block group, a multiple nerve block group, and a control group. All patients were treated postoperatively using patient-controlled intravenous analgesia with morphine. Pain intensity at rest, during flexion and extension, and morphine consumption were compared between groups over three days.

resultsA total of 90 patients completed the study protocol. Patients who received multiple nerve blocks experienced superior analgesia and had reduced morphine consumption during the postoperative period compared to the other two groups. Pain intensity during flexion was significantly lower in the "blocks" groups versus the control group. Morphine consumption was significantly higher in the control group.

conclusionsPain relief after total knee arthroplasty immediately after surgery and on the first postoperative day was significantly superior in patients who received multiple blocks preoperatively, with morphine consumption significantly lower during this period. A preoperative femoral nerve block alone produced partial and insufficient analgesia immediately after surgery and on the first postoperative day. (Clinical trial registration number (NIH): NCT01303120).

Identifiers

PMID28178436
PMCPMC5298367

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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.