• Conor Crowley, Michelle M Dowsey, Colm Quinn, Michael Barrington, and Peter F M Choong.
• Department of Orthopaedics, St. Vincent's Hospital, Melbourne, Victoria.
• ANZ J Surg. 2012 Apr 1; 82 (4): 207-14.

BackgroundRegional and local anaesthetic techniques are thought to improve postoperative pain control and functional outcomes following total knee arthroplasty, potentially leading to a reduction in hospital length of stay.ObjectivesThe objective of this study was to evaluate the reporting quality and discuss the clinical findings of the available literature on these modalities that included length of stay as a study outcome.Data SourcesThe electronic databases Pubmed, Scopus, Medline, Web of Science and Cochrane library were searched using key words.Review MethodsEight-hundred and forty-three papers were identified in the search. Fifteen of these met the inclusion criteria. Eight further studies were identified from their reference lists to give a final total of 23 studies that were reported against the consolidated standards of reporting trials (CONSORT) 2001 statement checklist.ResultsThe mean criteria CONSORT score was 17.3/22 (79%). The majority of studies that compared femoral nerve blocks with placebo or conventional pain management modalities failed to demonstrate a significant reduction in length of stay. All studies that compared femoral nerve blocks with epidurals found no significant difference in length of stay. Only half of the studies comparing local anaesthetic techniques to placebo or conventional pain management methods found a significant reduction in length of stay.ConclusionsThe reporting quality has specific deficiencies in the areas of sample size calculation, randomization whilst there was under-reporting of blinding. Regional and local anaesthetic techniques have not demonstrated a clear reduction in hospital length of stay. Epidurals and femoral nerve blocks have similar impacts on length of stay.© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

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