Comparative postoperative analgesia with femoral nerve block '3-in-1' and with fascia iliaca compartment nerve block after hip alloarthroplasty

Lončar-Stojiljković, Dragana; Stojiljković, Miloš P.; Golijanin, Ranko; Novaković-Bursać, Snježana; Škrbić, Ranko

doi:10.5937/mckg50-10893

Cited by 4 publications

(11 citation statements)

References 13 publications

(17 reference statements)

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“…Four articles [ 11 – 14 ] reported that TJAs were performed by same teams. Three studies [ 11 , 13 , 15 ] received premedication for pain relief. All participates received patient-controlled analgesia (PCA) with opioids as an adjunct concomitant pain management.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies [ 11 – 15 ] reported the length of hospital stay for the groups. A random-effects model was used because significant heterogeneity was identified in the pooled results ( χ 2 = 18.83, df = 4, I 2 = 78.8%, P = .001).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies [ 11 – 15 ] reported the postoperative complications of nausea and vomiting. A fixed-effects model was used because no significant heterogeneity was found among these studies ( χ 2 = 4.01, df = 4, I 2 = 0.3%, P = .405).…”

Section: Resultsmentioning

confidence: 99%

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Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

et al. 2017

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Background: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.Methods:A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study. Cochrane Hand book for Systematic Reviews of Interventions was used for assessment of the included studies and risk of bias was shown. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software.Results:Five RCTs including 308 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of visual analog scale (VAS) score at 12 hours (SMD = −0.080, 95% CI: −0.306 to 0.145, P = .485), 24 hours (SMD = 0.098, 95% CI: −0.127 to 0.323, P = .393), and 48 hours (SMD = −0.001, 95% CI: −0.227 to 0.225, P = .993). No significant differences were found regarding opioid consumption at 12 hours (SMD = 0.026, 95% CI: −0.224 to 0.275, P = .840), 24 hours (SMD = 0.037, 95% CI: −0.212 to 0.286, P = .771), and 48 hours (SMD = −0.016, 95% CI: −0.265 to 0.233, P = .900). In addition, no significant increase of complications was identified between groups.Conclusion: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 ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

et al. 2017

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“…Preoperatively nerve block was applied in 13 studies [ 4 – 6 , 14 – 18 , 20 – 24 ], and postoperative nerve block was used in 1 study [ 19 ]. 5 studies [ 6 , 16 , 20 , 22 , 23 ] employed the general anesthesia, 4 studies [ 4 , 5 , 14 , 19 ] used regional anesthesia, and 5 studies [ 15 , 17 , 18 , 21 , 24 ] did not mention the detailed method of anesthesia. Fentanyl was used for standard general anesthesia.…”

Section: Resultsmentioning

confidence: 99%

Is Femoral Nerve Block Superior to Fascia Iliac Block in Hip Surgery? Meta-Analysis of Randomized Controlled Trials

Han

2022

BioMed Research International

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Background. Femoral nerve block (FNB) and fascia iliac compartment block (FICB) are alternative methods of pain relief during hip surgery. Nevertheless, the effectiveness and safety of FNB compared with FICB are yet to be fully determined. Methods. Electronic databases were systematically searched. Only randomized controlled trials (RCTs) on hip surgery were included. Postoperatively, the pain scores at different time points, narcotic requirements in 24 h, mean arterial pressure, spinal anesthesia (SA) time, patient satisfaction, and adverse effect rates between the two groups were extracted throughout the study. Results. Fourteen RCTs including 1179 patients were included. Compared to the FICB, FNB decreased the VAS scores postoperatively at 24 h at rest ( P < 0.05 ) and the incidence rate of some side effects (nausea, vomiting, and sedation) ( P < 0.05 ). However, compared to the FICB, no significant difference was found in the FNB regarding the VAS scores postoperatively at any of the other time points (2 min, 20 min, 2 h, 24 h at movement, 48 h at rest, and 48 h at movement). Patients in both groups had similar narcotic needs after 24 h, mean arterial pressure, SA time, and patient satisfaction ( P > 0.05 ). Conclusions. FNB has more advantages in reducing VAS scores postoperatively at 24 h at rest and the odds of some adverse effects. A better quality RCT is needed to properly compare FNB with FICB.

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“…[29][30][31] Present results were also similar to the ones obtained in the same clinical settings, but in patients subjected to total hip replacement. 38 When it comes to pain control during and after TKA, five anaesthetic/analgesic techniques are being used: (1) general anaesthesia (2) spinal anaesthesia, (3) spinal and peripheral anaesthesia,…”

Section: Resultsmentioning

confidence: 99%

Multimodal neural block analgesia versus morphine analgesia after elective knee surgery

Lončar-Stojiljković¹

2019

Scripta Medica

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Background: Total knee arthroplasty has become a standard for treatment of endstage knee osteoarthritis. Due to intense and complex knee innervation, there is a need to improve the anaesthetic/analgesic approach to such operations. The aim of this randomised clinical trial was to compare the analgesic efficacy of the classical regimen and two of those based on the nerve blocks. Methods: A total of 60 patients was included and subjected to elective total knee arthroplasty under the general balanced anaesthesia. They were randomised to receive postoperatively (1) only morphine 5-10 mg q6h and paracetamol 1 g q6h (MP), (2) femoral nerve block (FNB) or (3) fascia iliac compartment nerve block (FICNB). Nerve blocks were produced by a single administration of 30-40 ml of bupivacaine 0.5%. Pain intensity, duration of neural block and additional consumption of analgesics were recorded postoperatively. Results: There were no demographic differences among the three groups of patients. Pain intensity was significantly lower in the two nerve block groups than in the MP group. The same two groups also demanded significantly less analgesics postoperatively than the MP group. Cardiovascular control was significantly better in the nerve block groups. There were no significant differences between the FNB and FIC-NB groups of patients regarding any of the studied parameters. Conclusion: In comparison with the classical MP analgesia, use of FNB or FICNB after the elective total knee arthroplasty results in lower pain scores, lower systolic blood pressure and less consumption of analgesics in the immediate postoperative course.

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Comparative postoperative analgesia with femoral nerve block '3-in-1' and with fascia iliaca compartment nerve block after hip alloarthroplasty

Cited by 4 publications

References 13 publications

Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty

Is Femoral Nerve Block Superior to Fascia Iliac Block in Hip Surgery? Meta-Analysis of Randomized Controlled Trials

Multimodal neural block analgesia versus morphine analgesia after elective knee surgery

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