Comparison of intravenous pethidine infusion with ‘3 in 1’ lumbar plexus block after anterior cruciate ligament reconstruction

Network meta‐analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction

“…The full details of the regional anaesthetic techniques are shown in online Supporting Information (Appendix S3). Briefly, ultrasound guidance alone was used by 14 studies [69, 70, 75, 83, 84, 89, 92, 95, 101, 102, 108, 110, 112, 116], nerve stimulation alone in 18 studies [81, 85, 87, 90, 93, 96, 97, 103, 105, 106, 111, 114, 115, 120, 121, 123, 124, 129] or either ultrasound and/or nerve stimulation guidance in eight studies [71, 72, 77, 78, 82, 91, 109, 113]. One study [104] did not specify nerve localisation technique.…”

“…A total of 25 studies (1749 patients) [69, 70, 77–83, 85, 90–94, 96, 101, 111, 115, 116, 118, 120–123] reported postoperative opioid related complications. Across the included studies, there were a total of 27 pairwise comparisons and eight regional anaesthetic techniques investigated: single‐injection FNB; single‐injection ACB; single‐injection LIA; single‐injection FNB combined with single‐injection SNB; single‐injection FNB combined with single‐injection LIA; continuous FNB; continuous FNB combined with single‐injection LIA; and control (systemic analgesia) (online Supporting Information, Appendix S17).…”

“…A total of 28 studies (1611) [69, 73–75, 78, 80, 81, 83, 85, 87, 90–93, 96, 99–101, 103, 105, 106, 109, 110, 115, 121, 122, 129] assessed block‐ or infiltration‐related complications. Overall, nerve block related complications were reported for 15/420 patients after single‐injection FNB, 2/48 patients after single‐injection FNB combined with single‐injection SNB and 1/92 patients after single‐injection FNB combined with single‐injection LIA.…”

“…Of these, 34 were excluded due to their lack of randomised nature or being a crossover design (n = 2) [35, 36]; having an ineligible surgery or not having data for the ACL subgroup (n = 5) [37–41]; not having an active comparator group (n = 2) [42, 43]; or being the only study identified evaluating the specific comparison (n = 25) [44–68]. Subsequently, a total of 61 [69–129] full text randomised trials were considered for inclusion; however, after additional review, four [125–128] were excluded due to evaluating a technique that was not attached to any of the other nodes in the network. Thus, a total of 57 [69–124, 129] full‐text randomised trials were included in the systematic review and network meta‐analysis.…”

“…Subsequently, a total of 61 [69–129] full text randomised trials were considered for inclusion; however, after additional review, four [125–128] were excluded due to evaluating a technique that was not attached to any of the other nodes in the network. Thus, a total of 57 [69–124, 129] full‐text randomised trials were included in the systematic review and network meta‐analysis. The flow diagram for study inclusion is depicted in Fig.…”