Evidence map›Paper›PMID 33417022›Full record

SynthesisArchives of orthopaedic and trauma surgery2022

Combined application of adductor canal block and local infiltration anesthesia in primary total knee arthroplasty: an updated meta-analysis of randomized controlled trials.

Xu Mingdeng, An Yuzhang, Xu Xiaoxiao, An Yucheng, Wang Xin, Jiang Dianming

Registry-linked trialAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07350252 (Postoperative Analgesia in Patients Undergoing Knee Replacement Surgery - a Study Comparing Intraoperative Local Infiltration Analgesia Only With Ultrasound-guided Nerve Blocks Added to Intraoperative Local Infiltration Analgesia, a Randomized Clinical Trial), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% 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.

NCT07350252 phase4recruitingnot on this mapstarted 2026, after this paper: background citation

Postoperative Analgesia in Patients Undergoing Knee Replacement Surgery - a Study Comparing Intraoperative Local Infiltration Analgesia Only With Ultrasound-guided Nerve Blocks Added to Intraoperative Local Infiltration Analgesia, a Randomized Clinical Trial

TypeinterventionalSponsorRegion SkaneRan2026 to 2027Enrolled200ConditionsOsteo Arthritis of the KneeArmsRopivacain 5 mg/ml + Clonidine
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Intrathecal nalbuphine at two doses reduces opioid use and pain after total knee arthroplasty: a randomized controlled trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Trial
  3. Article
  4. Review
  5. Article
  6. [Research progress on analgesic effect of adductor canal block after knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023
    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

6 authors at 1 institution in 1 country.

Xu MingdengDepartment of Orthopaedic Surgery, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, 1# Shuanghu Road, Yubei District, Chongqing City, 401120, China.
An YuzhangDepartment of Orthopaedic Surgery, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, 1# Shuanghu Road, Yubei District, Chongqing City, 401120, China.
Xu XiaoxiaoDepartment of Pediatry, Chongqing Health Center for Women and Children, Chongqing City, 401147, China.
An YuchengDepartment of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, Chongqing City, 401120, China.
Wang XinDepartment of Orthopaedic Surgery, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, 1# Shuanghu Road, Yubei District, Chongqing City, 401120, China.
Jiang DianmingDepartment of Orthopaedic Surgery, The Third Affiliated Hospital of Chongqing Medical University, ChongQing Medical University, 1# Shuanghu Road, Yubei District, Chongqing City, 401120, China. 3102973492@qq.com.
Chongqing Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerioperative pain after total knee arthroplasty (TKA) may seriously affect the rapid recovery of patients. The purpose of this study was to assess whether the combined use of adductor canal block (ACB) and local infiltration anesthesia (LIA) can further reduce postoperative pain and improve early functional recovery. MATERIALS AND

methodsPubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) comparing ACB + LIA and LIA alone in primary TKA. The primary outcomes were visual analog scale (VAS) scores at rest and walking, morphine consumption, range of motion (ROM) at 24 and 48 h postoperatively and distance walked. The secondary outcomes were the length of stay, the incidence of nausea and vomiting, and the total complications. Subgroup analyses were performed on the VAS at rest and walking, morphine consumption, and distance walked at 24, 48, and 72 h postoperatively.

resultsA total of 10 RCTs involving 797 patients were enrolled in this meta-analysis. The results demonstrated that the combined application of ACB + LIA had a lower resting VAS at 24 h postoperatively (p = 0.02) and the walking score at 24 (p = 0.0002) and 48 h (p = 0.02) postoperatively compared with LIA alone. Similarly, the combined ACB + LIA group also had less morphine consumption at 48 h postoperatively (p = 0.0005) and had a higher ROM score at 24 h (p = 0.01) postoperatively compared to the LIA group. There were no statistical differences in length of stay, distance walked, and incidence of nausea and vomiting.

conclusionThe current meta-analysis showed that ACB + LIA significantly reduced postoperative walking pain and morphine consumption and promoted rapid recovery in the early postoperative period. There is no statistical difference in the length of stay and ROM after 72 h in the two groups.

Indexed as

Arthroplasty, Replacement, KneeNerve BlockAnalgesics, OpioidAnesthesia, LocalAnesthetics, LocalHumansMorphineNauseaPostoperative PainRandomized Controlled Trials as TopicVomitingAnalgesics, OpioidAnesthetics, LocalMorphineAdductor canal blockLocal infiltration anesthesiaPainTotal knee arthroplasty

Identifiers

PMID33417022
OpenAlexW3118935681

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.