Cochrane · systematic review · CD011608
Nerve blocks or no nerve blocks for pain control after elective hip replacement (arthroplasty) surgery in adults
Guay, J, Johnson, RL, Kopp, S · Cochrane Database of Systematic Reviews · 2017 · 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
14
current version
GRADE rated
13
No studies
1
Included studies
NR
No studies 1 · 7.1%Ungraded 0 · 0%Very low 5 · 35.7%Low 4 · 28.6%Moderate 3 · 21.4%High 1 · 7.1%
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
Peripheral nerve blocks compared to systemic analgesia for elective primary total hip replacement
Population: adults undergoing elective primary total hip replacement
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest on arrival in postoperative care unit Visual/verbal analogue scale Peripheral nerve blocks vs systemic analgesia | no estimate extracted | 9 studies · 429 participants | Moderate Downgraded: risk of bias |
Total number of nerve block‐related complications Peripheral nerve blocks vs systemic analgesia | no estimate extracted | NR | No studies |
Acute confusional state Complete loss of time and space orientation Peripheral nerve blocks vs systemic analgesia | RR 0.1 [0.02, 0.54] | 1 study · 225 participants | Very low Downgraded: risk of bias, imprecision |
Pruritus Peripheral nerve blocks vs systemic analgesia | RR 0.16 [0.04, 0.7] | 2 studies · 259 participants | Very low Downgraded: risk of bias, imprecision |
Hospital length of stay Objective actual measurement Peripheral nerve blocks vs systemic analgesia | SMD 0.75 | 2 studies · 249 participants | Very low Downgraded: risk of bias, imprecision |
Walking at postoperative day 1 Objective actual measurement Peripheral nerve blocks vs systemic analgesia | RD 0.01 | 2 studies · 278 participants | Very low Downgraded: risk of bias, imprecision |
Patient satisfaction Subjective scales Peripheral nerve blocks vs systemic analgesia | SMD 0.67 [0.45, 0.89] | 5 studies · 363 participants | Low Downgraded: risk of bias |
Peripheral nerve block compared to neuraxial block for elective primary total hip replacement
Population: adults undergoing elective primary total hip replacement
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at rest on arrival in postoperative care unit Verbal/visual analogue scale. Scale from: 0 to 10 Peripheral nerve block vs neuraxial block | SMD 0.39 | 4 studies · 118 participants | Moderate Downgraded: risk of bias |
Total number of block‐related complications Peripheral nerve block vs neuraxial block | RD 0 | 5 studies · 334 participants | Low Downgraded: imprecision |
Aute confusional state Disorientation Peripheral nerve block vs neuraxial block | RR 0.29 [0.01, 6.69] | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision |
Pruritus Subjective scale Peripheral nerve block vs neuraxial block | RR 0.33 [0.19, 0.58] | 6 studies · 299 participants | Moderate Downgraded: imprecision |
Hospital length of stay Peripheral nerve block vs neuraxial block | MD 0.19 | 2 studies · 64 participants | Low Downgraded: risk of bias, imprecision |
Time to first walk Peripheral nerve block vs neuraxial block | no estimate extracted | 3 studies · 94 participants | Low Downgraded: risk of bias, imprecision |
Patient satisfaction Peripheral nerve block vs neuraxial block | SMD 0.08 | 6 studies · 307 participants | High |