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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2017 | Research article

Intrathecal morphine versus femoral nerve block for pain control after total knee arthroplasty: a meta-analysis

Authors: Yi Tang, Xu Tang, Qinghua Wei, Hui Zhang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

Abstract

Background

This meta-analysis aims to illustrate the efficacy and safety of intrathecal morphine (ITM) versus femoral nerve block (FNB) for pain control after total knee arthroplasty (TKA).

Methods

In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, Cami Info. Inc., Casalini databases, EBSCO databases, Verlag database and Google database. Data on patients prepared for TKA surgery in studies that compared ITM versus FNB for pain control after TKA were collected. The main outcomes were the visual analogue scale (VAS) at 6, 12, 24, 48 and 72 and total morphine consumption at 12, 24 and 48 h. The secondary outcomes were complications that included postoperative nausea and vomiting (PONV) and itching. Stata 12.0 was used for pooling the data.

Results

Five clinical studies with a total of 225 patients (ITM group = 114, FNB group = 111) were ultimately included in the meta-analysis. The results revealed that the ITM group was associated with a reduction of VAS at 6, 12, 24, 48 and 72 h and total morphine consumption at 12, 24 and 48 h. There was no significant difference between the occurrences of PONV. However, the ITM group was associated with an increased occurrence of itching after TKA.

Conclusions

Some immediate analgesic efficacy and opioid-sparing effects were obtained with the administration of ITM when compared with FNB. The complications of itching in the ITM group were greater than in the FNB group. The sample size and the quality of the included studies were limited. A multi-centre RCT is needed to identify the optimal method for reaching maximum pain control after TKA.

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Title: Intrathecal morphine versus femoral nerve block for pain control after total knee arthroplasty: a meta-analysis
Authors: Yi Tang
Xu Tang
Qinghua Wei
Hui Zhang
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-017-0621-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intrathecal morphine versus femoral nerve block for pain control after total knee arthroplasty: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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