Evidence map›Paper›PMID 39559456›Full record

ArticleJournal of pain research2024

Continuous Adductor Canal Block Compared to Epidural Anesthesia for Total Knee Arthroplasty.

Isaac G Freedman, Michael R Mercier, Anoop R Galivanche, Mani Ratnesh S Sandhu, Mark Hocevar, Harold Gregory Moore, Jonathan N Grauer, Lee E Rubin, Jinlei Li

Abstract read
In one paragraph

Article in Journal of pain research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

9 authors.

Isaac G FreedmanDepartment of Anesthesiology, Critical Care & Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-2603-4201
Michael R MercierDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06511, USA.
Anoop R GalivancheDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06511, USA.
Mani Ratnesh S SandhuDepartment of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Mark HocevarWarren Alpert School of Medicine, Brown University, Providence, RI, USA.
Harold Gregory MooreDepartment of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jonathan N GrauerDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06511, USA.
Lee E RubinDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, 06511, USA.
Jinlei LiDepartment of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0003-4026-2569

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: To compare the efficacy of a postoperative continuous adductor canal block (cACB) with and without a steroid adjuvant to that of epidural analgesia (EA). Methods: Patients who underwent primary total TKA at a single institution between July 2011-November 2017 were included for retrospective analysis. TKA patients were stratified into one of the three analgesia approaches: EA, cACB without steroid adjuvant, and cACB with steroid adjuvant. Hospital length of stay (LOS), discharge disposition, incidence of postoperative adverse events, and total milligram morphine equivalents (MME) requirements were compared between strata. Logistic regressions were performed to assess the independent effect of analgesia approach on prolonged LOS greater than 3 days (pLOS), non-home discharge, and total and daily MME requirements (tMME and dMME) following TKA. Results: Of the 4345 patients undergoing TKA, 1556 (35.83%) received EA, 2087 (48.03%) received cACB without steroids, and 702 (16.13%) cACB with steroids. cACB patients experienced lower rates of pLOS, higher rates of discharge to home than EA patients, and lower tMME and dMME. On multivariable analysis, cACB groups were at a lower odds of experiencing a pLOS compared to EA patients without steroids (OR = 0.64; 95% CI 0.49-0.84; with steroids: OR = 0.54; 95% CI 0.38-0.76). cACB groups had lower odds of a non-home discharge when compared to EA patients (without steroids OR = 0.42; 95% CI 0.36-0.48; with steroids: OR 0.22; 95% CI 0.18-0.27). On multivariable analysis, cACB groups required less tMME compared to the EA group (without steroids β=-290 mmE; 95% CI: -313 to -268 mmE; with steroids: β=-261 mmE; 95% CI: -289 to -233 mmE) as well as lower dMME (without steroids: β=-66 mmE/day; 95% CI -72 to -60 mmE/day; with steroids: β=-48 mmE/day; 95% CI -55 to -40 mmE/day). Conclusion: cACB was associated with greater discharge to home rates, lower rates of pLOS, and lower tMME and dMME consumption. Level of Evidence: Level III.

Indexed as

adductor canal blockcomplicationsdexamethasoneknee arthroplastylength of staymethylprednisolone acetatemilligram morphine equivalentsMMENSQIPpain controlsteroid

Identifiers

PMID39559456
PMCPMC11572497

What OpenQuestion holds

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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.