Postoperative pain relief after total knee arthroplasty: A Bayesian network meta-analysis and systematic review of analgesic strategies based on nerve blocks
Authors' conclusion
Considering both pain control and knee functional recovery, ACB + iPACK may be the optimal analgesic regimen for patients after TKA. At the same time, it significantly reduces pain and opioid consumption at 48 h. However, ACB + iPACK is not the recommended technique for short-term (24 h) pain control.
Study context
- Population
- Patients treated with any of four nerve block techniques after total knee arthroplasty (TKA); minimally invasive knee surgery excluded
- Participants
- 2,857 patients · 42 studies
- Comparison
- Femoral nerve block (FNB), adductor canal block (ACB), iPACK and genicular nerve block (GNB) after TKA
- Outcome
- Analgesic efficacy and functional recovery (ranking)
Methodological detailsRisk of bias assessed by the Cochrane risk of bias tool
- Risk of bias assessed by the Cochrane risk of bias tool
Pooled result
As reported in the abstract
- ACB + iPACK best for resting-pain relief at 48 h
- 78%
- ACB + iPACK best for movement-pain relief at 48 h
- 87%
- ACB + iPACK best for reducing opioid consumption at 48 h
- 90%
- FNB + iPACK most efficacious for resting-pain relief at 24 h
- 42%
- FNB + iPACK most efficacious for reducing opioid consumption at 24 h
- 68%
- GNB most efficacious for movement-pain relief at 24 h
- 94%
Original publication
Postoperative pain relief after total knee arthroplasty: A Bayesian network meta-analysis and systematic review of analgesic strategies based on nerve blocks. J Clin Anesth. Published 30 April 2024. doi:10.
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