Local Infiltration Analgesia Versus Femoral Nerve Block In Patients Analgesia After Total Knee Arthroplasty:a Systematic Review And Meta-analysis

Objective:To systematically evaluate the efficacy of diverse analgesic methods in patients after total knee arthroplasty(TKA),providing evidence for clinical therapy for pain after TKA.We also perform a meta-analysis towards local infiltration analgesia(LIA)versus femoral nerve block(FNB)in patients analgesia after TKA.Materials and methods:Inclusion criteria and exclusion criteria were made according to the objective.The related literatures were collected through Pubmed,Embase.Cochrane Central,Scopus and Web of Knowledge.The research data,which included visual analog score(VAS).range of movement(ROM),morphine consumption and length of hospital stay(LOS)were extracted two researchers independently.The review manager 5.3 were utilized to analyze the extract data.Results:A total of 763 cases(380 cases for LIA.383 cases f(or FNN)in 8 literatures were included.The average eligibility score of the literatures was 10.5±1.30.all of which were of high quality.VAS at rest or with activity in continuous FNB group was better than continuous LIA group,no significant difference between single-shot FNB group and single-shot LIA group in VAS at rest or with activity.Range of movement(ROM)was better in continuous FNB group compared with LIA continuous group.No remarkable discrepancy between continuous FNB group and continuous LIA group in RON with assistance or morphine consumption.The length of hospital stay was shorter in continuous/single-shot LIA group in comparison with continuous/single-shot FNB group.Conclusions:LIA versus FNB:patients with FNB have a better pain relief and ROM,which is apt for severe pain,while patients with LIA have shorter LOS.Compared with FNB,it is easier to perform LIA in clinical condition,for its simplicity,which is appropriate for moderate pain.