Evidence map›Paper›PMID 28499420›Full record

Trial reportBMC anesthesiology2017

Continuous femoral nerve blockade and single-shot sciatic nerve block promotes better analgesia and lower bleeding for total knee arthroplasty compared to intrathecal morphine: a randomized trial.

Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02882152 (Continuous Femoral Nerve Blockade and Single Shot Sciatic Nerve Block Compared to Intrathecal Morphine for Total Knee Arthroplasty), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% 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.

NCT02882152 nacompletednot on this map

Continuous Femoral Nerve Blockade and Single Shot Sciatic Nerve Block Compared to Intrathecal Morphine for Total Knee Arthroplasty

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2011 to 2014Enrolled40ConditionsKnee InjuriesArmsfemoral nerve blockade, morphine
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. 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

5 authors at 2 institutions in 1 country.

Nora Elizabeth Rojas ÁlvarezHospital das Clínicas, Divisão de Anestesia, Rua Dr. Ovídio Pires de Campos, 471, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010.
Rosemberg Jairo Gomez LedesmaHospital das Clínicas, Divisão de Anestesia, Rua Dr. Ovídio Pires de Campos, 471, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010.
Adilson HamajiInstitute of Orthopedics and Trauma Surgery, Hospital das Clínicas, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010.
Marcelo Waldir Mian HamajiInstitute of Orthopedics and Trauma Surgery, Hospital das Clínicas, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010.
Joaquim Edson VieiraDepartment of Surgery, University of São Paulo Medical School, Av. Dr. Arnaldo 455, sala 2345, Cerqueira César, São Paulo, SP, Brazil, CEP 01246-903. joaquimev@usp.br.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRUniversidade de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block.

methodsA randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group). Pain score from verbal numeric rating scale (VNRS) and morphine consumption during the first 72 h, as well as motor blockade, adverse effects, and postoperative bleeding were recorded. Analysis of variance of repeated measures with Bonferroni post-test, t-test and Fisher exact test were used for statistical analysis.

resultsThirty nine patients completed the study (M = 20; FI = 19 patients) and were similar except for higher age in the FI group. Motor blockade as well as movement pain during postanesthesia care unit (PACU) staying were not different between the groups, but movement pain was significantly lower in FI group after 24 h. Postoperative bleeding (ml) was lower in FI group.

conclusionsContinuous femoral nerve block combined with sciatic nerve block provides effective for postoperative analgesia in patients undergoing total knee arthroplasty, with lower pain scores after 24 h and a lower incidence of adverse effects and bleeding compared to intrathecal morphine.

trial registrationRetrospectively registered on https://clinicaltrials.gov/ under identifier NCT02882152 , 23

Indexed as

Arthroplasty, Replacement, KneeFemoral NerveNerve BlockSciatic NerveAgedAnalgesics, OpioidAnesthesia, SpinalFemaleHumansInjections, SpinalMaleMiddle AgedMorphinePain MeasurementPostoperative HemorrhagePostoperative PainAnalgesics, OpioidMorphineAnalgesiaAnesthesiaArthroplastyConductionKneeNerve BlockPainPostoperativeReplacement

Identifiers

PMID28499420
PMCPMC5429542
OpenAlexW2613897467

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.