Articles: nerve-block.
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Cochrane Db Syst Rev · Sep 2015
Review Meta AnalysisUltrasound guidance for upper and lower limb blocks.
Ultrasound-guided peripheral nerve blocks may yield better sensory and motor block, reduce supplementation & minor complications. Use of ultrasound alone is faster than when using with nerve stimulation.
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Orthop Traumatol Sur · Sep 2015
Review Meta AnalysisLocal infiltration analgesia versus femoral nerve block in total knee arthroplasty: a meta-analysis.
Local infiltration analgesia (LIA) and femoral nerve block (FNB) are both used for the pain management after total knee arthroplasty (TKA). Controversy still remains regarding the optimal technique for pain relief in patients undergoing TKA. The purpose of this meta-analysis was to compare the analgesia achieved with LIA and the one from FNB following TKA. ⋯ Level II, meta-analysis and systematic review.
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Review Meta Analysis Comparative Study
Analgesia for total knee arthroplasty: a meta-analysis comparing local infiltration and femoral nerve block.
Patients frequently experience postoperative pain after a total knee arthroplasty; such pain is always challenging to treat and may delay the patient's recovery. It is unclear whether local infiltration or a femoral nerve block offers a better analgesic effect after total knee arthroplasty. We performed a systematic review and meta-analysis of randomized controlled trials to compare local infiltration with a femoral nerve block in patients who underwent a primary unilateral total knee arthroplasty. ⋯ A sensitivity analysis was conducted to evaluate potential sources of heterogeneity. While the numeric rating scale values for pain upon movement (MD-0.62; 95%CI: -1.13 to -0.12; p=0.02) in the first 24 hours differed significantly between the patients who received local infiltration and those who received a femoral nerve block, there were no differences in the numeric rating scale results for pain at rest (MD-0.42; 95%CI:-1.32 to 0.47; p=0.35) or opioid consumption (MD 2.92; 95%CI:-1.32 to 7.16; p=0.18) in the first 24 hours. Local infiltration and femoral nerve block showed no significant differences in pain intensity at rest or opioid consumption after total knee arthroplasty, but the femoral nerve block was associated with reduced pain upon movement.
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Review Meta Analysis
Improving Analgesic Efficacy and Safety of Thoracic Paravertebral Block for Breast Surgery: A Mixed-Effects Meta-Analysis.
While most trials of thoracic paravertebral nerve blocks (TPVB) for breast surgery show benefit, their effect on postoperative pain intensity, opioid consumption, and prevention of chronic postsurgical pain varies substantially across studies. Variability may result from use of different drugs and techniques. ⋯ TPVB reduces postoperative pain and opioid consumption, and has a limited beneficial effect on the quality of recovery. From all the techniques that were evaluated, only the addition of fentanyl, and performing multilevel blocks were associated with improved acute analgesia. TPVB may reduce chronic postsurgical pain at 6 months.
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Review Meta Analysis Comparative Study
The Comparison of Local Infiltration Analgesia with Peripheral Nerve Block following Total Knee Arthroplasty (TKA): A Systematic Review with Meta-Analysis.
Total knee arthroplasty (TKA) is usually associated with severe post-operative pain, which can prevent rehabilitation of patients' knee function and influence the satisfaction of surgery. Local infiltration analgesia (LIA) is a method that has been applied in clinical practice recently. However, the clinical use of this method is still under discussion. ⋯ During the analysis, we strictly filtered papers and chose ones that had fewer disturbance variables. We also analyzed the heterogeneity. We conclude that when compared with PNB, pain control with LIA is at least comparable.