Articles: nerve-block.
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Review Meta Analysis Comparative Study
Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty: A meta-analysis from randomized controlled trials.
This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties. ⋯ There is no significant differences of VAS scores at 12-48 hour and opioids consumption at 12-48 hour between two groups following total joint arthroplasty. No increased risk of nausea, vomiting and pruritus was observed in both groups. More high-quality large RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of FNB with FIB. The present meta-analysis exists some limitations that should be noted: (1) Only five articles were included in present meta-analysis, although all of them are recently published RCTs, the sample size are relatively small; (2) Functional outcome is an important parameter, due to the insufficiency of relevant data, we cannot perform a meta-analysis. (3) Dose and types of local anesthetics are varied, which may influence the results; (4) The duration of follow up is relatively short which leads to underestimating complications. (5) Publication bias in present meta-analysis may influence the results.
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Review Meta Analysis Comparative Study
Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis.
Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve block for pain control in patients undergoing TSA. ⋯ Current meta-analysis indicates that compared with interscalene nerve block, liposomal bupivacaine had comparative effectiveness on reducing both pain scores and the length of hospital stay. However, studies with more patients and better-designed methods are needed to establish the optimal regimen and the safety of liposomal bupivacaine in TSA patients.
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Review Meta Analysis Comparative Study
Comparison of local infiltration analgesia and sciatic nerve block for pain control after total knee arthroplasty: a systematic review and meta-analysis.
This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after total knee arthroplasty (TKA). ⋯ FNB-combined SNB provides superior pain relief and less morphine consumption within the first 24 h compared FNB-combined LIA in total knee arthroplasty. In addition, there were fewer side effects associated with SNB. Because the sample size and the number of included studies were limited, a multicenter RCT is needed to identify the effects of the two kinds of methods and further work must include range of motion analyses and functional test.
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Journal of anesthesia · Jun 2017
Review Meta AnalysisClinical safety and effectiveness of transversus abdominis plane (TAP) block in post-operative analgesia: a systematic review and meta-analysis.
Transversus abdominis plane (TAP) blocks can provide analgesia postoperatively for a range of surgeries. Abundant clinical trials have assessed TAP block showing positive analgesic effects. This systematic review assesses safety and effectiveness outcomes of TAP block in all clinical settings, comparing with both active (standard care) and inactive (placebo) comparators. ⋯ Postoperative pain within 24 h was reduced or at least equivalent in TAP block compared to its comparators. Therefore, TAP block is a safe and effective procedure compared to standard care, placebo and other analgesic techniques. Further research is warranted to investigate whether the TAP block technique can be improved by optimizing dose and technique-related factors.
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Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. ⋯ High-quality evidence shows that regional blockade reduces pain on movement within 30 minutes after block placement. Moderate-quality evidence shows reduced risk for pneumonia, decreased time to first mobilization and cost reduction of the analgesic regimen (single shot blocks).