Author : Eric Albrecht
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis The Analgesic Efficacy of Local Infiltration Analgesia Versus Peripheral Nerve Block After Anterior Cruciate Ligament Reconstruction: a Systematic Review and Meta-analysis by : Eric Albrecht
Download or read book The Analgesic Efficacy of Local Infiltration Analgesia Versus Peripheral Nerve Block After Anterior Cruciate Ligament Reconstruction: a Systematic Review and Meta-analysis written by Eric Albrecht and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of StudyMany authors consider blockade of the femoral nerve distribution the gold standard analgesic treatment after anterior cruciate ligament reconstruction. However, some argue an alternative approach of local infiltration analgesia, using local anesthetics injection into the surgical site, has similar efficacy. The objectives of this meta-analysis were to compare the analgesia and functional outcomes of both treatments following anterior ligament reconstruction.Materials and MethodsThe methodology followed the PRISMA statement guidelines. The primary outcomes were pain scores at rest (analogue scale, 0-10) in the early (0-2 postoperative hours), intermediate (3-12 postoperative hours), and late postoperative periods (13-24 postoperative hours). Secondary outcomes included range of motion, quadriceps muscle strength, and complication rates (neurologic events, cardiovascular events, falls, knee infections, or knee chondrolysis).Results and DiscussionTen trials, including 588 patients, were identified. Pain scores in the early (mean difference: 1.6; 95%CI: 0.2, 2.9mg; I2=97%; p=0.02), intermediate (mean difference: 1.2; 95%CI: 0.4, 1.5; I2=85%; p=0.002) and late (mean difference: 0.7; 95%CI: 0.1, 1.4; I2=82%; p=0.03) postoperative periods were significantly lower in patients who received a femoral nerve block (table 1). The quality of evidence for our primary outcomes were moderate to high according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group System. Regarding the functional outcomes, only one trial reported range of motion at 48 postoperative hours, which was found to be similar between groups (mean difference: -5u00b0; 95%CI: -14, 4u00b0; p = 0.27). No trials sought to record side-effects such as neurologic events, cardiovascular events, falls, knee infections, or knee chondrolysis.ConclusionFemoral nerve block provides superior postoperative analgesia after anterior cruciate ligament reconstruction when compared to local infiltration analgesia. The impact of improved analgesia on function remains unanswered due to the lack of functional outcomes reported in existing literature.
