Abstract:
BACKGROUND:This study aimed to evaluate the effectiveness of continuous adductor canal block (CACB) versus continuous femoral nerve block (CFNB) in postoperative analgesia and early rehabilitation of patients with total knee arthroplasty (TKA). METHODS:The Cochrane Library, PubMed, and EMbase were systematically searched to retrieve literature comparing efficacy of CACB versus CFNB on pain relief and functional recovery in knee replacement patients until December 2018, without language limitation. Meta-analysis was performed using RevMan 5.3 software. RESULTS:A total of 7 clinical randomized controlled trials and 4 retrospective studies were included, involving 484 cases in the CACB group and 491 in the CFNB group. The results of the meta-analysis showed that the visual analogue scores (VAS) at rest were similar between the CACB group and the CFNB group at 8 hours (standard mean difference(SMD) = -0.26, 95% confidence interval(CI): -0.62, 0.11), 12 hours (SMD = -0.02, 95%CI: -0.50, 0.47), 24 hours (SMD = 0.05, 95%CI: -0.22, 0.33), and 48 hours (SMD = -0.10, 95%CI: -0.29, 0.09) after TKA (P > .05 for all). The muscle strength of patients in the CACB group post-operation was significantly improved than those of the CFNB group (SMD = 0.81; 95% CI: 0.35, 1.26; P = .0005). There were no significant differences in the amount of opioids consumption and the incidence of postoperative fall between CACB and CFNB (P > .05). CONCLUSION:The analgesic effects of CACB versus CFNB are equivalent after TKA. CACB has less effect on the quadriceps muscle strength, which is beneficial to the early postoperative activities and functional rehabilitation.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Zhang Z,Wang Y,Liu Ydoi
10.1097/MD.0000000000018056subject
Has Abstractpub_date
2019-11-01 00:00:00pages
e18056issue
48eissn
0025-7974issn
1536-5964pii
00005792-201911290-00029journal_volume
98pub_type
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