April 19, 2017

Meta-analysis ranks efficacy of pain management modalities for total knee

By: Judy Mathias
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Editor's Note

The combination of femoral and sciatic nerve blocks is the overall best approach to pain management after total knee arthroplasty, finds this meta-analysis.

The best five modalities for pain at rest were: femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks.

For reducing opioid consumption, the best five were: femoral/sciatic/obturator, femoral/obturator, lumbar plexus/sciatic, lumbar plexus, and femoral/sciatic blocks.

The best for range of motion were femoral/sciatic blocks.

Blocking multiple nerves was preferable to blocking any single nerve, periarticular infiltration, or epidural analgesia, with femoral/sciatic being the best, the researchers conclude.

A Network Meta-analysis of 170 Randomized Controlled Trials

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