Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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.
See this image and copyright information in PMC

References

    1. Zhu S, Qian W, Jiang C, et al. . Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J 2017;93:736–42. - PMC - PubMed
    1. Gaffney CJ, Pelt CE, Gililland JM, et al. . Perioperative pain management in hip and knee arthroplasty. Orthop Clin North Am 2017;48:407–19. - PubMed
    1. Affas F. Local infiltration analgesia in knee and hip arthroplasty efficacy and safety. Scand J Pain 2016;13:59–66. - PubMed
    1. Crumley Aybar BL, Gillespie MJ, Gipson SF, et al. . Peripheral nerve blocks causing increased risk for fall and difficulty in ambulation for the hip and knee joint replacement patient. J Perianesth Nurs 2016;31:504–19. - PubMed
    1. Saglik Y, Yazicioglu D, Cicekler O, et al. . Investigation of Effects of Epidural Anaesthesia Combined with General Anaesthesia on the Stress Response in Patients Undergoing Hip and Knee Arthroplasty. Turkish J Anaesthesiol Reanim 2015;43:154–61. - PMC - PubMed