Cochrane · systematic review · CD009941
Femoral nerve blocks for acute postoperative pain after knee replacement surgery
Chan, EY, Fransen, M, Parker, DA, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
20
No studies
4
Included studies
NR
No studies 4 · 15.4%Ungraded 2 · 7.7%Very low 0 · 0%Low 3 · 11.5%Moderate 11 · 42.3%High 6 · 23.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
FNB (any type) compared with PCA opioid for knee replacement surgery
Population: patients with knee replacement surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs PCA opioid | no estimate extracted | 19 studies · 1066 participants | Moderate Downgraded: inconsistency |
Pain on movement at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs PCA opioid | no estimate extracted | 17 studies · 1017 participants | Moderate Downgraded: inconsistency |
Neurological injury FNB (any type) vs PCA opioid | no estimate extracted | 4 studies · 390 participants | Ungraded |
Opioid consumption at 24 hours using morphine equivalents Scale from zero to 150 mg FNB (any type) vs PCA opioid | no estimate extracted | 20 studies · 1156 participants | High |
Nausea and/or vomiting FNB (any type) vs PCA opioid | RR 0.47 [0.33, 0.68] | 16 studies · 1100 participants | High |
Knee flexion range of motion (degree) FNB (any type) vs PCA opioid | no estimate extracted | 11 studies · 596 participants | Moderate Downgraded: inconsistency |
Participant satisfaction with analgesia (point) Scale from zero to 10 FNB (any type) vs PCA opioid | no estimate extracted | 4 studies · 180 participants | Low Downgraded: risk of bias, inconsistency |
FNB (any type) compared with epidural analgesia for knee replacement surgery
Population: patients with knee replacement surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs epidural analgesia | no estimate extracted | 6 studies · 328 participants | Moderate Downgraded: risk of bias, inconsistency |
Pain on movement at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs epidural analgesia | no estimate extracted | 6 studies · 317 participants | High |
Neurological injury FNB (any type) vs epidural analgesia | no estimate extracted | 4 studies · 306 participants | Ungraded |
Opioid consumption at 24 hours using morphine equivalents Scale from zero to 150 mg FNB (any type) vs epidural analgesia | no estimate extracted | 5 studies · 341 participants | High |
Nausea and/or vomiting FNB (any type) vs epidural analgesia | RR 0.63 [0.41, 0.97] | 4 studies · 183 participants | Moderate Downgraded: risk of bias, inconsistency |
Knee flexion range of motion (degrees) FNB (any type) vs epidural analgesia | no estimate extracted | 6 studies · 328 participants | High |
Participant satisfaction with analgesia (point) Scale from zero to 10 FNB (any type) vs epidural analgesia | no estimate extracted | 2 studies · 120 participants | Low Downgraded: risk of bias, inconsistency |
FNB (any type) compared with local infiltration analgesia for knee replacement surgery
Population: patients with knee replacement surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs local infiltration analgesia | no estimate extracted | 4 studies · 216 participants | Moderate Downgraded: inconsistency |
Pain on movement at 24 hours Visual analogue scale Scale from zero to 10 FNB (any type) vs local infiltration analgesia | no estimate extracted | 3 studies · 153 participants | Low Downgraded: inconsistency |
Neurological injury: not reported FNB (any type) vs local infiltration analgesia | no estimate extracted | NR | No studies |
Opioid consumption at 24 hours using morphine equivalents Scale from zero to 150 mg FNB (any type) vs local infiltration analgesia | no estimate extracted | 1 study · 40 participants | Moderate |
Nausea and/or vomiting FNB (any type) vs local infiltration analgesia | RR 1.71 [0.64, 4.62] | 3 studies · 177 participants | Moderate |
Participant satisfaction with analgesia Scale from zero to 10 FNB (any type) vs local infiltration analgesia | no estimate extracted | NR | No studies |
Continuous FNB compared with single‐shot FNB for knee replacement surgery
Population: patients with knee replacement surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest at 24 hours Visual analogue scale Scale from zero to 10 Continuous FNB vs single‐shot FNB | no estimate extracted | 4 studies · 272 participants | Moderate Downgraded: inconsistency |
Pain on movement at 24 hours Visual analogue scale Scale from zero to 10 Continuous FNB vs single‐shot FNB | no estimate extracted | 4 studies · 272 participants | High |
Neurological injury: not reported Continuous FNB vs single‐shot FNB | no estimate extracted | NR | No studies |
Opioid consumption at 24 hours using morphine equivalents Scale from 0 to 150 mg Continuous FNB vs single‐shot FNB | no estimate extracted | 3 studies · 236 participants | Moderate Downgraded: inconsistency |
Nausea and/or vomiting Continuous FNB vs single‐shot FNB | RR 0.55 [0.2, 1.56] | 2 studies · 214 participants | Moderate Downgraded: inconsistency |
Participant satisfaction with analgesia: not reported Continuous FNB vs single‐shot FNB | no estimate extracted | NR | No studies |