Comparisons between perioperative continuous femoral nerve block and patient controlled analgesia for analgesia in primary total knee arthroplasty: a Meta-analysis
10.3760/cma.j.issn.1001-8050.2017.09.005
- VernacularTitle:全膝关节置换围术期持续股神经阻滞与患者自控镇痛效果的Meta分析
- Author:
Lukai ZHANG
1
,
2
;
天津中医药大学研究生院
;
Jianxiong MA
;
Mingjie KUANG
;
Bin LU
;
Ying WANG
;
Fengbo LI
;
Jie ZHAO
;
Zhengrui FAN
;
Xinlong MA
Author Information
1. 300050天津,天津医院骨科研究所
2. 天津中医药大学研究生院
- Keywords:
Arthroplasty,replacement,knee;
Randomized controlled trial;
Analgesia;
Meta-analysis
- From:
Chinese Journal of Trauma
2017;33(9):792-800
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of continuous femoral nerve block (CFNB) versus patient controlled analgesia (PCA) for analgesia in primary total knee arthroplasty (TKA) through a Meta-analysis.Methods All randomized controlled trials (RCTs) which compared about the efficacy and safety of CFNB versus PCA for analgesia in primary TKA,were searched from Cochrane Library,Embase,PubMed,CBM,VIP,Wang Fang database and CNKI.At the same time,conference papers were identified manually.A quality assessment of the included literature was evaluated by Cochrane system evaluation manually.Revman 5.3 software was used for the Meta-analysis to compare visual analogue scale (VAS),hospital for special surgery knee score (HSS),western Ontario and McMaster university of orthopedic index (WOMAC),patient satisfactory degree,and incidences of complications (nausea,vomit,dizziness,somnolence,itch of skin,etc).Results Twenty-four RCTs involving 1896 patients were identified including CFNB (946 cases) and PCA (950 cases) application of TKA.The pooled results illustrated that CFNB could reduce VAS in rest (MD =-1.28,95％ CI-1.56,-1.00,P ＜ 0.05) and VAS in movement (MD =-0.98,95％ CI-1.38,-0.58,P ＜ 0.05),increase HSS (MD =2.13,95％ CI 0.12,4.14,P ＜0.05),reduce WOMAC(MD =-0.97,95％ CI-1.83,-0.11,P ＜ 0.05),increase patient satisfactory degree (RR =1.27,95 ％ CI 1.10,1.46,P ＜ 0.05) and at the same time reduce the incidences of nausea,vomit,dizziness,somnolence and itch of skin (RR =0.32,95％CI0.24,0.43,P＜0.05).Conclusion Compared with PCA,CFNB analgesia can reduce VAS,WOMAC score,improve the postoperative HSS and patient satisfaction degree,and decrease the risk of complications.
