The comparison of adductor canal block with femoral nerve block following total knee arthroplasty: a systematic review with meta-analysis
The comparison of adductor canal block with femoral nerve block following total knee arthroplasty: a systematic review with meta-analysis
复制标题
全膝关节置换术后收肌管阻滞与股神经阻滞的比较：荟萃分析的系统评价
DOI：
10.1007/s00540-016-2194-1
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发表时间：
2016-10-01
影响因子：
2.8
通讯作者：
Yu, Bin
中科院分区：
文献类型：
--
作者：
Zhao, Xing-qi;Jiang, Nan;Yu, Bin
目的虽然有多项研究比较了内收肌管阻滞（ACB）和股神经阻滞（FNB）用于全膝关节置换术（TKA）后镇痛的临床效果，但两种方法的争议主要集中在股四头肌力量和活动能力的恢复方面。本研究的目的是比较，在系统评价和荟萃分析，ACB的临床疗效与FNB.MethodsWe系统搜索随机对照试验比较FNB与ACB的TKA后的镇痛Pubmed和科克伦图书馆从成立到2015年4月30日。没有出版语言的限制。试验质量进行了评估，使用修改后的Jadad量表，并将符合条件的数据汇总为Meta analysis.ResultsFive研究348例。结果显示，接受ACB的患者的股四头肌力量和活动能力恢复与接受FNB的患者相似或更好。在内收肌力量、疼痛评分[静息时]方面，两种策略的疗效相似（p= 0.86），膝关节屈曲时或之后（p= 0.31）]，类阿片消耗量（p= 0.99），阿片类药物相关不良反应（p= 0.60），住院时间（p= 0.42），患者满意度（p= 0.57），封锁成功率（p= 0.20）。结论本研究表明，接受ACB的TKA患者的股四头肌力量和活动能力恢复与接受FNB的患者相似，甚至更好。综合考虑，ACB可能是目前TKA术后较好的镇痛策略。
PurposeAlthough several studies have compared the clinical efficacy of an adductor canal block (ACB) to that of a femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA), disputes mainly exist in the recovery of quadriceps strength and mobilization ability between the two methods. The aim of the present study was to compare, in a systematic review and meta-analysis, the clinical efficacy of ACB with that of FNB.MethodsWe systematically searched randomized controlled trials comparing FNB with ACB for analgesia after TKA in Pubmed and the Cochrane Library from inception to April 30th 2015. There was no limitation of publication language. Trial quality was assessed using the modified Jadad scale, and eligible data were pooled for meta-analysis.ResultsFive studies of 348 patients were included. Outcomes showed that patients who received ACB had similar or better recovery of quadriceps strength and mobilization ability than those that underwent FNB. Similar efficacy was found between the two strategies regarding adductor strength, pain scores [at rest (p= 0.86), at or after knee flexion (p= 0.31)], opioid consumption (p= 0.99), opioid-associated adverse effects (p= 0.60), length of hospital stay (p= 0.42), patient satisfaction (p= 0.57), and success rate of blockade (p= 0.20).ConclusionsThe present study suggests that TKA patients who receive ACB can achieve similar or even better recovery of quadriceps strength and mobilization ability than those treated with FNB. Taken as a whole, ACB may be a better analgesia strategy after TKA at present.