Evidence map›Paper›PMID 31048897›Full record

SynthesisPloS one2019

Efficacy and safety of femoral nerve block for the positioning of femur fracture patients before a spinal block - A systematic review and meta-analysis.

Yuan-Pin Hsu, Chin-Wang Hsu, Karen Chia Wen Chu, Wen-Cheng Huang, Chyi-Huey Bai, Chun-Jen Huang, Sheng-Wei Cheng, Jin-Hua Chen, Chiehfeng Chen

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Peripheral nerve blocks for hip fractures in adults.The Cochrane database of systematic reviews · 2020
    Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
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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.

Yuan-Pin HsuEmergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Chin-Wang HsuEmergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Karen Chia Wen ChuEmergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Wen-Cheng HuangEmergency Department, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Chyi-Huey BaiDepartment of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Chun-Jen HuangGraduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Sheng-Wei ChengGraduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.ORCID 0000-0003-4514-1678
Jin-Hua ChenGraduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan.
Chiehfeng ChenGraduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.ORCID 0000-0002-1595-6553
Wan Fang Hospital · TWTaipei Medical University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe evidence supporting the benefit of femoral nerve block (FNB) for positioning before spinal anesthesia (SA) in patients suffering from a femur fracture remains inconclusive. In the present study, the authors intended to determine the efficacy and safety of FNB versus an intravenous analgesic (IVA) for positioning before SA in patients with a femur fracture.

methodPubMed, EMBASE, Cochrane, and Scopus databases were searched up to January 2018. We included randomized controlled studies (RCTs) and observational studies that compared FNB versus IVA for the positioning of patients with femur fracture receiving SA. The primary outcome was pain scores during positioning within 30 min before SA. Secondary outcomes were the time for SA, additional analgesic requirements, anesthesiologist's satisfaction with the quality of positioning for SA, participant acceptance, and hemodynamic changes. A random-effects model was used to synthesize the data. We registered the study at PROSPERO with an ID of CRD42018091450.

resultsTen studies with 584 patients were eligible for inclusion. FNB achieved significantly lower pain scores than IVA during positioning within 30 min before SA (pooled standardized mean deviation (SMD): -1.27, 95% confidence interval (CI): -1.84 to -0.70, p < 0.05). A subgroup analysis showed that the analgesic effect was larger in patients in the sitting position for SA than a non-sitting position (sitting position vs non-sitting: pooled SMD: -1.75 (p < 0.05) vs -0.61 (not significant). A multivariate regression showed that the analgesic effect was also associated with age and the total equivalent amount as lidocaine after adjusting for gender (age: coefficient 0.048, p < 0.05; total equivalent amount as lidocaine: coefficient 0.005, p < 0.05). Patients receiving FNB also had a significantly shorter time for SA, greater anesthesiologist satisfaction, and higher patient acceptance than patients receiving IVA. The use of local anesthetics did not produce significant clinical hemodynamic change.

conclusionCompared to IVA, FNB was an effective and safe strategy for the positioning of femur fracture patients for a spinal block, particularly patients who received SA in the sitting position.

Indexed as

Anesthesia, SpinalFemoral NerveNerve BlockAnalgesicsFemaleFemoral FracturesHumansLidocaineMaleAnalgesicsLidocaine

Identifiers

PMID31048897
PMCPMC6497313
OpenAlexW2942889918

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.