Evidence map›Paper›PMID 33748305›Full record

ArticleOrthopaedic journal of sports medicine2021

Intra-articular Morphine and Ropivacaine Injection Provides Efficacious Analgesia As Compared With Femoral Nerve Block in the First 24 Hours After ACL Reconstruction: Results From a Bone-Patellar Tendon-Bone Graft in an Adolescent Population.

Brendon C Mitchell, Matthew Y Siow, Andrew T Pennock, Eric W Edmonds, Tracey P Bastrom, Henry G Chambers

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  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

6 authors at 2 institutions in 1 country.

Brendon C MitchellDepartment of Orthopaedic Surgery, University of California, San Diego, San Diego, California, USA.
Matthew Y SiowDepartment of Orthopaedic Surgery, University of California, San Diego, San Diego, California, USA.
Andrew T PennockDivision of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.
Eric W EdmondsDivision of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.
Tracey P BastromDivision of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.
Henry G ChambersDivision of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA.
Rady Children's Hospital-San Diego · USUniversity of California, San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid consumption and patient satisfaction are influenced by a surgeon's pain-management protocol as well as the use of adjunctive pain mediators. Two commonly utilized adjunctive pain modifiers for anterior cruciate ligament (ACL) reconstruction are femoral nerve blockade and intra-articular injection; however, debate remains regarding the more efficacious methodology. HYPOTHESIS: We hypothesized that intra-articular injection with ropivacaine and morphine would be found to be as efficacious as a femoral nerve block for postoperative pain management in the first 24 hours after bone-patellar tendon-bone (BTB) ACL reconstruction. STUDY

designCohort study; Level of evidence, 3.

methodsCharts were retrospectively reviewed for BTB ACL reconstructions performed by a single pediatric orthopaedic surgeon from 2013 to 2019. Overall, 116 patients were identified: 58 received intra-articular injection, and 58 received single-shot femoral nerve block. All patients were admitted for 24 hours. Pain scores were assessed every 4 hours. Morphine milligram equivalents (MMEs) consumed were tabulated for each patient.

resultsOpioid use was 24.3 MMEs in patients treated with intra-articular injection versus 28.5 MMEs in those with peripheral block (

conclusionWithin the limitations of this study, we could identify no significant difference in MME consumption between the single-shot femoral nerve block group and intra-articular injection group in the first 24 hours postoperatively. While peripheral block is associated with lower opioid consumption in the first 4 hours after surgery, patients receiving intra-articular block require fewer opioids 16 to 24 hours postoperatively. Given these findings, we propose that intra-articular injection is a viable alternative for analgesia in adolescent patients undergoing BTB ACL reconstruction.

Indexed as

ACL reconstructionanterior cruciate ligamenthumanintra-articular injectionmorphine milligram equivalentspainperipheral nerve block

Identifiers

PMID33748305
PMCPMC7940747
OpenAlexW3135472314

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.