Evidence map›Paper›PMID 37821677›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2024

Proximal versus distal adductor canal catheters for total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.

Rafael A Lombardi, Isabela R Marques, Pedro E P Carvalho, Gabriela R Brandao, Jasmeen Kaur, Ashish Sakharpe, Nicholas E Heiser

Open access · hybridAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-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.

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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. 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

7 authors at 6 institutions in 3 countries.

Rafael A LombardiDepartment of Anesthesiology, University of Nebraska Medical Center, 984455 Nebraska Medical Center, Omaha, NE, 68198, USA. rarskylombardi@unmc.edu.ORCID http://orcid.org/0000-0001-7104-8237
Isabela R MarquesDivision of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.
Pedro E P CarvalhoDepartment of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Gabriela R BrandaoFederal University of Health Sciences of Porto Alegre, Porto Alegra, Brazil.
Jasmeen KaurDepartment of Anesthesiology, Augusta University Medical Center, Augusta, GA, USA.
Ashish SakharpeDepartment of Anesthesiology, Augusta University Medical Center, Augusta, GA, USA.
Nicholas E HeiserDepartment of Anesthesiology, University of Nebraska Medical Center, 984455 Nebraska Medical Center, Omaha, NE, 68198, USA.
Augusta University Health · USNebraska Medical Center · USUniversidade Federal de Ciências da Saúde de Porto Alegre · BRUniversidade Federal de Minas Gerais · BRUniversitat Internacional de Catalunya · ESUniversity of Nebraska Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTotal knee arthroplasty (TKA) is associated with severe postoperative pain. Continuous adductor canal blockade provides analgesia while preserving quadriceps muscle strength. Nevertheless, uncertainty still exists as to the optimal adductor canal catheter placement approach. We sought to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the analgesic effects of proximal vs distal adductor canal catheters in patients undergoing TKA. SOURCE: We systematically searched PubMed, EMBASE, and Cochrane for RCTs comparing distal and proximal adductor canal catheters for TKA regarding critical clinical outcomes in adult patients. Statistical analysis was performed using R version 4.1.2 (R Foundation for Statistical Computing, Vienna, Austria). Heterogeneity was assessed using the Cochran Q test and I PRINCIPAL

findingsSix RCTs and 352 patients were included, of whom 151 (42.9%) were male, and 175 (49.7%) were randomized to undergo proximal adductor canal catheter placement. Due to the randomized nature of the studies, baseline characteristics were similar between groups. There were no statistical differences between proximal and distal adductor canal catheters regarding cumulative opioid consumption in the first 24 hr (mean difference [MD], -4.86; 95% confidence interval [CI], -15.19 to 5.47; P = 0.36; four RCTs; 240 patients); pain scores at rest (MD, 0.41; 95% CI, -1.23 to 0.40; P = 0.32; six RCTs; 350 patients); and pain scores with movement for the first 24 hr (MD, -0.25; 95% CI, -0.85 to 0.35; P = 0.42; four RCTs; 246 patients). In the TSA, the required information size was not reached, and the Z-curve did not cross the monitoring boundaries in any of the endpoints.

conclusionThese findings suggest that proximal vs distal adductor canal catheter placement in patients undergoing TKA may be equally effective for the outcomes of opioid consumption in the first 24 hr, pain scores at rest, and pain scores with movement in the first 24 hr. Nevertheless, TSA findings suggest insufficient power to definitively conclude no differences between the two techniques. STUDY REGISTRATION: PROSPERO (CRD42022353576); registered 25 August 2022.

Indexed as

Arthroplasty, Replacement, KneeCathetersNerve BlockPostoperative PainRandomized Controlled Trials as TopicFemaleHumansMaleadductor canal blockcontinuous peripheral nerve blockmeta-analysistotal knee replacement

Identifiers

PMID37821677
OpenAlexW4387522494

What OpenQuestion holds

Textmetadata
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.