Evidence map›Paper›PMID 39390370›Full record

ArticleBMC anesthesiology2024

Comparative efficacy of intrathecal morphine and adductor canal block in the knee arthroplasty population: a retrospective multi-centre cohort study.

Brigid Brown, Tim Soon Cheok, David Worsley, Hidde M Kroon, Nathan Davis, Ruurd L Jaarsma, Job Doornberg, D-Yin Lin

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Brigid BrownDepartment of Anesthesiology, Flinders Medical Centre, Flinders Drive, Bedford Park Adelaide, South Australia, 5042, Australia. brigid.brown@sa.gov.au.
Tim Soon CheokDepartment of Orthopedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
David WorsleyDepartment of Orthopedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Hidde M KroonDepartment of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Nathan DavisCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Ruurd L JaarsmaCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Job DoornbergCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
D-Yin LinDepartment of Anesthesiology, Flinders Medical Centre, Flinders Drive, Bedford Park Adelaide, South Australia, 5042, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFinding the balance of good postoperative analgesia while facilitiating mobility is important for a safe and satisfactory patient experience during Total Knee Arthroplasty (TKA). This study aimed to compare the efficacy of intrathecal morphine, adductor canal block, and their combination in optimizing pain management and postoperative recovery in TKA patients. This retrospective analysis of prospectively collected data evaluated postoperative pain scores, time to mobilisation, and length of hospital stay.

methods1006 consecutive patients undergoing elective TKA across two large tertiary centres were included over six years. They were divided into one of four groups according to the type of analgesia received: Group N patients received no neuraxial morphine or regional block. Group B patients received adductor canal block (ACB) only. Group M patients received intrathecal morphine (ITM) but no regional block. Group BM patients received both ACB and ITM.

resultsPatients who received an ACB had faster postoperative mobilization compared to those without (p < 0.001). Patients in Group BM had the lowest pain scores at rest (Visual Analogue Scale (VAS) 2.9) and with movement (VAS 5.3), while Group B patients experienced the highest pain scores at rest (VAS 3.7) and on movement (VAS 6.5) (p = 0.005). Patients who received ITM had the lowest opioid requirements (p < 0.001). There was no significant differences between groups in requirement for rescue pain management strategies (p = 0.06).

conclusionsThe combination of ITM and ACB in patients undergoing TKA provides improved postoperative analgesia with lower postoperative opioid requirement and earlier mobilization compared with ACB or ITM alone.

Indexed as

Analgesics, OpioidArthroplasty, Replacement, KneeInjections, SpinalMorphineNerve BlockPostoperative PainAgedCohort StudiesFemaleHumansLength of StayMaleMiddle AgedPain MeasurementRetrospective StudiesAnalgesics, OpioidMorphineAdductor canalAnalgesiaAnesthesiologyIntrathecalMorphineRegional

Identifiers

PMID39390370
PMCPMC11465912

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Registered trials

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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.