Network meta‐analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction
Authors' conclusion
Regional anaesthesia techniques that target both the femoral and sciatic nerve distributions, namely a combination of single-injection nerve blocks, provide the most consistent analgesic benefits for anterior cruciate ligament reconstruction compared with all other techniques but will most likely impair postoperative function.
Study context
- Population
- Patients undergoing anterior cruciate ligament reconstruction
- Participants
- 4,069 patients · 57 trials
- Comparison
- Regional anaesthesia techniques vs each other and vs systemic analgesia alone
- Outcome
- Opioid consumption
- Follow-up
- First 24 h postoperatively
Methodological detailsfrequentist approach
- Frequentist approach
Pooled result
As reported in the abstract
first 24 h
Single-injection femoral + sciatic nerve block: highest probability of reducing opioid consumption
78%
Further pooled results
AUC for pain severity over 24 h
- Single-injection femoral + sciatic nerve block: highest probability of reduction
- 90%
Functional recovery
- Local infiltration analgesia: highest probability of optimising functional recovery
- 88%
All analgesic outcomes
- Systemic analgesia, local infiltration analgesia and adductor canal block each poor performers
Safety
- Continuous femoral nerve block: highest probability of reducing opioid-related adverse effects
- 87%
Original publication
Network meta‐analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction. Anaesthesia. Published 3 November 2022. doi:10.
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