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Meta-Analysis
. 2021 Apr 9;100(14):e25450.
doi: 10.1097/MD.0000000000025450.

Femoral nerve block versus fascia iliaca block for pain control in knee and hip arthroplasties: A meta-analysis

Xiaohua Fan  1 , Fei Cao  2 , Ailin Luo  1
Affiliations
Meta-Analysis

Femoral nerve block versus fascia iliaca block for pain control in knee and hip arthroplasties: A meta-analysis

Xiaohua Fan et al. Medicine (Baltimore). .

Abstract

Background: This meta-analysis aimed to compare the efficiency of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) for pain management in knee and hip surgeries.

Methods: We searched four electronic databases (Pubmed, Embase, Cochrane library database, Web of Science) from inception to January 2019. Only randomized controlled trials (RCTs) were included. Two review authors independently extracted data for each included study. Primary outcomes were visual analogue scale at 12 hours, 24 hours, 48 hours, total morphine consumption, the length of hospital stay and the occurrence of nausea and vomiting. Standardized mean difference (SMD) or risk ratio (RR) and 95% confidence intervals (CIs) were calculated for continuous outcomes and discontinuous outcomes respectively. We used the Cochrane Risk of Bias tool to assess risk of bias. Stata 12.0 was used for meta-analysis.

Results: Finally, 7 RCTs involving 508 patients (FICB = 254, FNB = 254) were included in this meta-analysis. Compared with FNB group, FICB has no benefit for visual analogue scale at 12 hours (SMD = 0.02, 95% CI, -0.15 to 0.19; P = .820), 24 hours (SMD = -0.02, 95% CI, -0.22 to 0.18; P = .806), and 48 hours (SMD = -0.02, 95% CI, -0.22 to 0.19; P = .872). No significant differences were found regarding total morphine consumption (SMD = -0.07, 95% CI, -0.29 to 0.15; P = .533). What's more, there was no significant difference between the length of hospital stay and the occurrence of nausea and vomiting (P > .05).

Conclusion: FICB has equivalent pain control and morphine-sparing efficacy when compared with FNB. More high-quality RCTs are needed to identify the optimal drugs and volume of local infiltration protocols.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow of trials through the meta-analysis.
Figure 2
Figure 2
A, the risk of bias summary, +, no bias; –, bias;?, bias unknown.
Figure 3
Figure 3
Risk of bias of summary of the included randomized controlled trials.
Figure 4
Figure 4
Forest plots of the included studies comparing the VAS scores at 12 hours.
Figure 5
Figure 5
Forest plots of the included studies comparing the VAS scores at 24 hours.
Figure 6
Figure 6
Forest plots of the included studies comparing the VAS scores at 48 hours.
Figure 7
Figure 7
Forest plots of the included studies comparing the total morphine consumption.
Figure 8
Figure 8
Forest plots of the included studies comparing the length of hospital stay.
Figure 9
Figure 9
Forest plots of the included studies comparing the occurrence of nausea and vomiting.
Figure 10
Figure 10
Funnel plot of the VAS score at 12 hours.
Figure 11
Figure 11
Begg test of the VAS score at 12 hours.
Figure 12
Figure 12
Egger test of the VAS score at 12 hours.
Figure 13
Figure 13
Sensitivity analysis of the VAS score at 12 hours.
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