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前交叉韧带重建患者内收肌管阻滞与股神经阻滞的效果:一项系统评价与荟萃分析方案

Effects of adductor canal block versus femoral nerve block in patients with anterior cruciate ligament reconstruction: A protocol for a systematic review and meta-analysis.

作者信息

Liu Xuwen, Zhou Jiawen, Mao Guping, Yu Qiao, Wu Xin, Sun Hong, Yang Hua

机构信息

Department of Clinical Medical College, Guizhou Medical University, Guiyang.

Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou.

出版信息

Medicine (Baltimore). 2019 Sep;98(36):e16763. doi: 10.1097/MD.0000000000016763.

Abstract

OBJECTIVE

It is reported that both adductor canal block (ACB) and femoral nerve block (FNB) are commonly used methods for postoperative analgesia in anterior cruciate ligament (ACL) reconstruction. Currently, no record has compared the efficacy of postoperative pain relief and the influence to quadriceps strength between them. This study aims to provide a protocol to compare the efficacy and safety between ACB and FNB for the postoperative analgesia of ACL reconstruction.

METHODS

This study will be performed in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. Online databases including PubMed, Embase, Web of Science, Cochrane Library, Wanfang database, and the Chinese National Knowledge Infrastructure database will be systematically searched from their inception up May 31, 2019. All randomized controlled trials will be included in present meta-analysis. The quality of enrolled literatures will be evaluated by using the Cochrane Collaboration Risk of bias Tool. Statistical analysis will be calculated by the Review Manager 5.3.

RESULTS

This review will investigate the efficacy and safety of ACB compared with FNB in patients undergoing ACL reconstruction. The primary outcomes are visual analog scale, cumulative opioid consumption during 24 hours after surgery, numerical rating scale, and the time to first straight-leg raise. The secondary outcomes include maximal voluntary isometric contraction, stretching torque at 3, 6 months' follow-up, and adverse effects.

CONCLUSION

Findings of this systematic review and meta-analysis will summarize the current evidence in postoperative analgesia for ACL reconstruction and also provide implications for clinical practice.

摘要

目的

据报道,内收肌管阻滞(ACB)和股神经阻滞(FNB)都是前交叉韧带(ACL)重建术后常用的镇痛方法。目前,尚无记录比较二者术后疼痛缓解效果及对股四头肌力量的影响。本研究旨在提供一个方案,比较ACB和FNB用于ACL重建术后镇痛的有效性和安全性。

方法

本研究将按照系统评价与Meta分析方案的首选报告项目指南进行。将系统检索包括PubMed、Embase、Web of Science、Cochrane图书馆、万方数据库和中国知网数据库在内的在线数据库,检索时间从建库至2019年5月31日。所有随机对照试验将纳入本Meta分析。采用Cochrane协作网偏倚风险工具评估纳入文献的质量。使用Review Manager 5.3进行统计分析。

结果

本综述将研究ACB与FNB相比在接受ACL重建患者中的有效性和安全性。主要结局指标为视觉模拟评分、术后24小时内阿片类药物累计消耗量、数字评定量表以及首次直腿抬高时间。次要结局指标包括最大自主等长收缩、随访3、6个月时的拉伸扭矩以及不良反应。

结论

本系统评价和Meta分析的结果将总结目前ACL重建术后镇痛的证据,并为临床实践提供启示。

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