WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Major knee surgery is common for end-stage disease or trauma, aiming to restore mobility and quality of life.
• Postoperative pain control remains a significant challenge following these procedures.
• Peripheral nerve blocks offer a localized analgesic approach for major knee surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of peripheral nerve blocks for postoperative pain control after major knee surgery.
• To compare peripheral nerve blocks against systemic analgesia, local infiltration, epidural, and spinal analgesia.

Main Methods:

• Systematic review and meta-analysis of participant-blind, randomized controlled trials (RCTs).
• Searched CENTRAL, MEDLINE, and EMBASE databases up to February 2014.
• Included 23 high-quality RCTs involving 1571 adult participants undergoing major knee surgery.

Main Results:

• Peripheral nerve blocks, as an adjunct to systemic analgesia, significantly reduced pain intensity at rest within 72 hours postoperatively compared to systemic analgesia alone.
• Pain intensity on movement was also significantly reduced between 48-72 hours postoperatively.
• Insufficient data prevented conclusions on other outcomes (analgesic consumption, range of motion, hospital stay) and comparisons with local infiltration, epidural, or spinal analgesia.

Conclusions:

• Peripheral nerve blocks effectively reduce pain intensity when used with systemic analgesia after major knee surgery.
• Further trials are necessary to establish comparative effectiveness against local infiltration, epidural, and spinal analgesia for various outcomes.