Background: This meta-analysis aimed to compare the efficiency of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) for pain management in knee and hip surgeries.
Methods: We searched four electronic databases (Pubmed, Embase, Cochrane library database, Web of Science) from inception to January 2019. Only randomized controlled trials (RCTs) were included. Two review authors independently extracted data for each included study. Primary outcomes were visual analogue scale at 12 hours, 24 hours, 48 hours, total morphine consumption, the length of hospital stay and the occurrence of nausea and vomiting. Standardized mean difference (SMD) or risk ratio (RR) and 95% confidence intervals (CIs) were calculated for continuous outcomes and discontinuous outcomes respectively. We used the Cochrane Risk of Bias tool to assess risk of bias. Stata 12.0 was used for meta-analysis.
Results: Finally, 7 RCTs involving 508 patients (FICB = 254, FNB = 254) were included in this meta-analysis. Compared with FNB group, FICB has no benefit for visual analogue scale at 12 hours (SMD = 0.02, 95% CI, -0.15 to 0.19; P = .820), 24 hours (SMD = -0.02, 95% CI, -0.22 to 0.18; P = .806), and 48 hours (SMD = -0.02, 95% CI, -0.22 to 0.19; P = .872). No significant differences were found regarding total morphine consumption (SMD = -0.07, 95% CI, -0.29 to 0.15; P = .533). What's more, there was no significant difference between the length of hospital stay and the occurrence of nausea and vomiting (P > .05).
Conclusion: FICB has equivalent pain control and morphine-sparing efficacy when compared with FNB. More high-quality RCTs are needed to identify the optimal drugs and volume of local infiltration protocols.
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http://dx.doi.org/10.1097/MD.0000000000025450 | DOI Listing |
Cureus
November 2024
Department of General Surgery, Juntendo University Nerima Hospital, Tokyo, JPN.
An obturator hernia (OH) is a rare type of hernia that accounts for a very small proportion of all hernias and cases of small bowel obstruction. This condition predominantly affects older, underweight individuals, with the vast majority of patients being women. Laparotomy with simple suture closure of the defect is commonly used as surgical treatment for OH.
View Article and Find Full Text PDFJBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFWiad Lek
December 2024
STATE INSTITUTION OF SCIENCE ≪CENTER OF INNOVATIVE HEALTHCARE TECHNOLOGIES≫ STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.
Objective: Aim: To compare the effectiveness of tumescent anesthesia and regional anesthesia under ultrasound guidance in terms of their impact on nociceptive and stress systems, as well as systemic hemodynamics, in patients with chronic venous disease of the lower extremities, undergoing surgical treatment.
Patients And Methods: Materials and Methods: Fifty patients (average age 48 ±15 years; 19 [38 %] males and 31 [62 %] females) with chronic venous disease of the lower extremities, who underwent surgical treatment (endovenous laser ablation and miniphlebectomy on one limb), were examined. Twenty-five patients (main group) underwent surgery under femoral nerve block with 150 mg of lidocaine and sciatic nerve block (popliteal fossa) with 150 mg of lidocaine under ultrasound guidance.
Reg Anesth Pain Med
December 2024
Faculty of Medicine, University of Geneva, Geneva, Switzerland
Introduction: Whether a popliteal plexus block improves postoperative pain following total knee arthroplasty remains debated. This randomized trial tested if adding a popliteal plexus block to a continuous femoral nerve block decreases postoperative opioid requirement.
Methods: We included 66 patients undergoing total knee arthroplasty.
Purpose: Hip deformity is frequent after childhood osteonecrosis in patients with sickle cell disease (SCD). When they are adults, they present a challenge as candidates for total hip arthroplasty (THA) because of abnormal bone development, their relative youth, and also because of their disease. Performing subtrochanteric osteotomy associated with THA is technically challenging, and healing of osteotomies has never been reported in this population with frequent osteonecrotic bone, whether using cemented or uncemented arthroplasties.
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