The Clinical journal of pain
-
Meta Analysis
Percutaneous Electrical Stimulation Improves Chronic Knee Pain and Function. A Systematic Review and Meta-analyses.
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of percutaneous electrical stimulation in the modulation of pain and its implication in the function of patients with a painful knee condition. ⋯ This review showed a positive effect of applying the percutaneous electrical stimulation for reducing pain and improving function in adults with a painful knee.
-
Both superficial and deep serratus anterior plane (SAP) blocks are effective for anterior chest wall surgeries, but there is little clarity on which is more effective. Hence, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the comparative efficacy of the 2 approaches for SAP block after anterior chest wall surgery. ⋯ Current evidence does not support the preference for one approach of SAP block over the other for postoperative pain. Based on the available data, we recommend further future trials to determine any differences between these interventions.
-
Meta Analysis
Genicular Nerve Block for Knee Osteoarthritis: A Systematic Review and meta-analysis of Randomized Clinical Trials.
Genicular nerve block (GNB) has emerged as a novel nonsurgical therapy for symptomatic knee osteoarthritis (KOA). The objective was to evaluate GNB versus placebo and other intra-articular (IA) therapies. ⋯ Although, GNB achieved the MCID for KOA pain and statistically significant results for knee functions. We cannot recommend its routine use besides being a safe procedure so far, evidence is fair on GNB for primary KOA due to study heterogeneity and limited follow-up.
-
Meta Analysis
Network Meta-analysis and Economic Evaluation of Neurostimulation Interventions for Chronic Non-surgical Refractory back Pain.
Different types of spinal cord stimulation (SCS) have been evaluated for the management of chronic nonsurgical refractory back pain (NSRBP). A direct comparison between the different types of SCS or between closed-loop SCS with conventional medical management (CMM) for patients with NSRBP has not been previously conducted, and therefore, their relative effectiveness and cost-effectiveness remain unknown. The aim of this study was to perform a systematic review, network meta-analysis (NMA) and economic evaluation of closed-loop SCS compared with fixed-output SCS and CMM for patients with NSRBP. ⋯ Current evidence showed that closed-loop and fixed-output SCS provide more benefits and cost-savings compared with CMM for patients with NSRBP.
-
Meta Analysis Comparative Study
Adductor Canal Block versus Femoral Nerve Block in Total Knee Arthroplasty: Network Meta-Analysis.
The quality of postoperative analgesia in total knee arthroplasty is crucial for patient recovery, rehabilitation, and hospital stay duration. In line with the above, а single-shot adductor canal block has been considered as an improved method over continuous femoral nerve block. However, continuous adductor canal block and single-shot femoral nerve block have been not adequately addressed in the discussion. This study aimed to compare the effectiveness of various types of adductor and femoral nerve blocks on clinically relevant outcomes in patients following total knee arthroplasty. ⋯ The shift from continuous femoral nerve block to single-shot adductor canal block as the preferred method for pain relief after total knee arthroplasty may be premature. While the latter improves mobility, it falls short in pain control and does not shorten hospital stays. Continuous adductor canal block shows promise but is currently underappreciated, and single-shot femoral nerve block is often overshadowed by other techniques in regional anesthesia. Further high-quality, multicenter randomized controlled trials are needed to validate these findings.