Single shot versus continuous technique adductor canal block for analgesia following total knee arthroplasty: A PRISMA-compliant meta-analysis

Medicine (Baltimore). 2019 May;98(20):e15539. doi: 10.1097/MD.0000000000015539.

Abstract

Background: An adductor canal block (ACB) provides recognized analgesia following total knee arthroplasty (TKA). This meta-analysis compared the single-injection ACB (SACB) with the continuous-injection ACB (CACB).

Method: Relevant studies were searched from PubMed (1996-October 2018), Embase (1980-October 2018), and Cochrane Library (CENTRAL, October 2018). Four randomized controlled trials (RCTs), which compared SACB with CACB, were included in our meta-analysis.

Results: Four RCTs met the inclusion criteria. Our pooled data indicated that the SACB group had similar efficacy compared with the CACB group in terms of morphine consumption (P = .19), time to first opioid request (P = .32), range of motion (P = .97), and visual analogue scale (VAS) scores at 24 hours at rest (P = .12) and movement (P = .24), without increasing the risk of complications (P = .97) and length of stay (P = .54).

Conclusion: The SACB technique provides similar analgesia in the 24 hours following TKA compared with CACB, while the CACB method was better over 48 hours.

Publication types

  • Meta-Analysis

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Arthroplasty, Replacement, Knee / methods*
  • Drug Administration Schedule
  • Humans
  • Length of Stay
  • Nerve Block / methods*
  • Pain Management / methods*
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Postoperative Complications / epidemiology
  • Randomized Controlled Trials as Topic
  • Range of Motion, Articular
  • Time Factors

Substances

  • Analgesics, Opioid