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前交叉韧带重建中收肌管阻滞与股神经阻滞用于疼痛管理的比较:随机对照试验的荟萃分析。

Comparison of adductor canal block and femoral nerve block for pain management in anterior cruciate ligament reconstruction: A meta-analysis of randomized controlled trials.

机构信息

Department of Anesthesiology, Shengjing Hospital of China Medical University, Liaoning, China.

出版信息

Medicine (Baltimore). 2022 Jun 24;101(25):e29295. doi: 10.1097/MD.0000000000029295.

Abstract

OBJECTIVE

To compare the efficacy of adductor canal block and femoral nerve block for pain management in patients with anterior cruciate ligament reconstruction.

METHODS

A computerized search was performed in the database of PubMed, Embase, Web of Science and Cochrane Library for randomized controlled trials. The outcome measures included visual analog scale, morphine consumption, quadriceps strength, length of hospitalization and postoperative adverse events. The risk of bias of randomized controlled trials was assessed according to the Cochrane Risk of Bias Tool. All quantitative syntheses were completed using STATA version 14.

RESULTS

Seven randomized controlled trials involving a total of 643 patients were included in our meta-analysis. The present meta-analysis indicated that there were no significant differences between the 2 groups in terms of postoperative pain score, opioid consumption, length of hospitalization or adverse effects after anterior cruciate ligament reconstruction. However, adductor canal block showed superior quadriceps strength and range of motion in the early postoperative period.

CONCLUSION

Adductor canal block shows similar and adequate analgesia compared to the femoral nerve block in anterior cruciate ligament reconstruction and adductor canal block can preserve a higher quadriceps strength and better range of motion.

摘要

目的

比较收肌管阻滞与股神经阻滞在治疗前交叉韧带重建患者疼痛管理中的疗效。

方法

在 PubMed、Embase、Web of Science 和 Cochrane Library 数据库中进行计算机检索,纳入随机对照试验。结局指标包括视觉模拟评分、吗啡用量、股四头肌肌力、住院时间和术后不良事件。根据 Cochrane 偏倚风险工具评估随机对照试验的偏倚风险。所有定量综合均使用 STATA 版本 14 完成。

结果

本 meta 分析共纳入 7 项随机对照试验,共计 643 例患者。本 meta 分析表明,在术后疼痛评分、阿片类药物用量、住院时间或前交叉韧带重建后不良反应方面,两组间无显著差异。然而,收肌管阻滞在术后早期具有更好的股四头肌肌力和运动范围。

结论

在治疗前交叉韧带重建患者疼痛管理方面,收肌管阻滞与股神经阻滞相比具有相似且足够的镇痛效果,收肌管阻滞可保持更高的股四头肌肌力和更好的运动范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/873c/9276137/937a9cddb3d1/medi-101-e29295-g001.jpg

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