Evidence map›Paper›PMID 40483183›Full record

SynthesisBritish journal of anaesthesia2025

Regional anaesthesia modalities for primary total hip arthroplasty: a systematic review and component network meta-analysis.

Kun-Han Lee, Jui-Chien Wang, Cheng-Yang Chang, Wei-Nung Teng, Hsin-Yi Wang, Chien-Ching Lee, Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Wei-Ming Chen

Abstract readNetwork Meta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. 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

10 authors.

Kun-Han LeeDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Jui-Chien WangDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Cheng-Yang ChangDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Wei-Nung TengDepartment of Anaesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Anaesthesiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Hsin-Yi WangDepartment of Anaesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Anaesthesiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Chien-Ching LeeDepartment of Anaesthesia, An Nan Hospital, China Medical University, Tainan, Taiwan, ROC; Department of Medical Sciences Industry, Chang Jung Christian University, Tainan, Taiwan, ROC.
Shang-Wen TsaiDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Cheng-Fong ChenDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC. Electronic address: cfchen.vghtpe@gmail.com.
Po-Kuei WuDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Wei-Ming ChenDepartment of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRegional nerve blocks potentially offer superior pain control for patients undergoing primary total hip arthroplasty. However, the optimal single-shot regional anaesthesia modality remains unclear.

methodsPubMed, Embase, Cochrane, and Web of Science databases were searched from inception to May 5, 2024. Randomised controlled trials comparing various single-shot regional anaesthesia modalities were included. Frequentist and component network meta-analyses were performed. The primary outcomes included static and dynamic pain (visual analogue scale [VAS]) at 6 and 12 h after operation and total morphine consumption at 24 h. Additional outcomes included opioid-related adverse effects, patient satisfaction, quality of recovery, and postoperative lower limb muscle power.

resultsEighty-seven randomised controlled trials were included. In static VAS, femoral nerve block ranked best (surface under the cumulative ranking curve (SUCRA)=92.8%), followed by lumbar plexus block (LPB) plus local infiltrative analgesia (LIA) (SUCRA=85.7%) at 6 h after operation. At 12 h after operation, LPB plus LIA was top ranked (SUCRA=89.2%), followed by quadratus lumborum block plus fascia iliaca compartment block (FICB) (SUCRA=84.8%). In dynamic VAS, pericapsular nerve group (PENG) block plus LIA (SUCRA=86.3%) and LPB plus LIA (SUCRA=83.4%) ranked best at 6 and 12 h after operation, respectively. In total morphine consumption at 24 h after operation, quadratus lumborum block plus FICB ranked highest (SUCRA=85.5%), followed by LPB plus LIA (SUCRA=82.2%) and PENG plus LIA (SUCRA=76.5%). LPB, FICB, and femoral nerve block were associated with increased motor blockade affecting quadriceps or adductor muscles based on qualitative analysis.

conclusionsCombined regional anaesthesia modalities, particularly PENG plus LIA, are favourable options for primary total hip arthroplasty procedures, as they result in lower pain scores, reduced opioid consumption, and motor-sparing effects in the early postoperative period. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42024544358).

Indexed as

Anesthesia, ConductionArthroplasty, Replacement, HipPostoperative PainAnalgesics, OpioidHumansNerve BlockPain MeasurementRandomized Controlled Trials as TopicAnalgesics, Opioidlocal infiltrative analgesianerve blockpain managementregional anaesthesiasystematic reviewtotal hip arthroplasty

Identifiers

PMID40483183
PMCPMC12308097

What OpenQuestion holds

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Read underepoch 390

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.