Continuous Peripheral Nerve Block Compared With Single-injection Peripheral Nerve Block: A Meta-analysis

Objective: Many practitioners consider continuous peripheral nerveblocks (cPNBs) to be superior to single-injection peripheral nerve blocks(siPNBs). Several randomized controlled trials have demonstrated improvedpain control, patient satisfaction, and other outcomes for patients with cPNBscompared with patients with siPNBs,whereas other trials have not shownsignificant differences. We sought to clarify any potential advantages ofcPNBs over siPNBs. Methods:Elecronic databases licluding PubMed、Google Scholar、 MEDLINE、 Ovid wrer searched between1995to2012.Randomized controlled trials (RCTs) were indentified on patientsundergoing continuous peripheral nerve block compared with single-injectionperipheral nerve block. In accordance with the strict inclusion and exclusionctriteria,Date were extracted from these trials by2reviewers independentlyto combine and analyze the results by RevMan5.0software.Results:Compared with siPNBs, cPNBs were associated with a decreased rating ofworst pain on postoperative day0(effect size [ES],–1.29；95%confidenceinterval [CI]，–2.19to–0.40；P=0.005), postoperative day1(ES，–1.87；95%CI，–2.44to–1.31；P＜0.001)，and postoperative day2(ES，–2.03；95%CI，–2.78to–1.290；P＜0.001)；decreased overall opioid use (ES，–15.70；95%CI，–21.84to–9.55；P＜0.001)；less nausea (ES，0.633；95%CI，0.407–0.983；P=0.043)； and higher patient satisfaction scores(weighted mean difference，2.04；95%CI,1.24–2.85； P＜0.001).Conclusions: Compared with siPNBs, cPNBs were associated with improved pain control, decreased need for opioid analgesics, less nausea, and greaterpatient satisfaction. The effect of cPNBs on other clinically relevantoutcomes, such as complications, long-term functional outcomes, or costs,remains unclear.