Effects of Combining Short‐ and Long‐Acting Local Anaesthetics in Peripheral Nerve Blocks—A Systematic Review With Meta‐Analysis and Trial Sequential Analysis
Authors' conclusion
Our assessment suggested that combining short and long-acting LA reduced block duration by 2½ h compared with long-acting LA and increased it by 3½ h compared with short-acting LA. The changes in duration of onset time were limited and likely not clinically relevant.
Study context
- Population
- Adults undergoing peripheral nerve blocks
- Participants
- 1,539 adults · 21 trials
- Comparison
- Combined short- and long-acting local anaesthetics (LA) vs either a short- or long-acting LA alone
- Outcome
- Duration of analgesia
Methodological detailstrial sequential analysis, risk of bias-2, Grading Recommendations Assessment, Development and Evaluation (GRADE)
- Trial sequential analysis
- Risk of bias-2
- GRADE
Pooled result
As reported in the abstract
MD, min (95% CI)P value
Combination vs Long-acting LAtau = 181 min, I2 = 96%, TSA-adj. 95% CI: −254 to −71, GRADE = moderate
−162(−246 to −79)
P < 0.01Combination vs Short-acting LATSA-adj. 95% CI: 150 to 282, GRADE = moderate
216(163–269)
P < 0.01Further pooled results
| Outcome | MD (min) (95% CI) | P value | |
|---|---|---|---|
| Onset time, combination vs long-acting LA | −8.0 (−11.5 to −4.6) | P < 0.01 | |
| −15−10−505Difference, min (linear scale) |
- Onset time, combination vs long-acting LA: tau = 7.8 min, I2 = 98%; Trial sequential analyses (TSA)-adj. 95% CI: −11.8 to −4.3; GRADE = low
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effects of Combining Short‐ and Long‐Acting Local Anaesthetics in Peripheral Nerve Blocks—A Systematic Review With Meta‐Analysis and Trial Sequential Analysis. Acta Anaesthesiol Scand. Published 30 October 2025. doi:10.
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