Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature

被引：115

作者：

Memtsoudis, Stavros G. ^{[1
,2
]}

Cozowicz, Crispiana ^{[3
]}

Bekeris, Janis ^{[3
]}

Bekere, Dace ^{[3
]}

Liu, Jiabin ^{[1
,2
]}

Soffin, Ellen M. ^{[1
,2
]}

Mariano, Edward R. ^{[4
,5
]}

Johnson, Rebecca L. ^{[6
]}

Go, George ^{[1
]}

Hargett, Mary J. ^{[1
]}

Lee, Bradley H. ^{[1
,2
]}

Wendel, Pamela ^{[1
,2
]}

Brouillette, Mark ^{[1
,2
]}

Kim, Sang Jo ^{[1
,2
]}

Baaklini, Lila ^{[1
,2
]}

Wetmore, Douglas S. ^{[1
,2
]}

Hong, Genewoo ^{[1
,2
]}

Goto, Rie ^{[1
]}

Jivanelli, Bridget ^{[1
]}

Athanassoglou, Vassilis ^{[7
]}

Argyra, Eriphili ^{[8
]}

Barrington, Michael John ^{[9
]}

Borgeat, Alain ^{[10
]}

De Andres, Jose ^{[11
]}

El-Boghdadly, Kariem ^{[12
]}

Elkassabany, Nabil M. ^{[13
]}

Gautier, Philippe ^{[14
]}

Gerner, Peter ^{[15
]}

Della Valle, Alejandro Gonzalez ^{[3
]}

Goytizolo, Enrique ^{[16
,17
]}

Guo, Zhenggang

Hogg, Rosemary ^{[18
]}

Kehlet, Henrik ^{[19
]}

Kessler, Paul ^{[20
]}

Kopp, Sandra ^{[21
]}

Lavand'homme, Patricia

Macfarlane, Alan ^{[22
]}

MacLean, Catherine ^{[23
,24
]}

Mantilla, Carlos ^{[25
,26
]}

McIsaac, Dan ^{[27
]}

McLawhorn, Alexander ^{[27
]}

Neal, Joseph M. ^{[16
,17
]}

Parks, Michael ^{[28
,29
]}

Parvizi, Javad ^{[30
]}

Peng, Philip ^{[31
]}

Pichler, Lukas ^{[32
]}

Poeran, Jashvant ^{[33
]}

Poultsides, Lazaros ^{[34
]}

Schwenk, Eric S. ^{[35
]}

Sites, Brian D. ^{[36
]}

机构：

[1] Hosp Special Surg, Dept Anesthesiol Crit Care & Pain Management, 535 E 70th St, New York, NY 10021 USA

[2] Weill Cornell Med Coll, Dept Anesthesiol Crit Care & Pain Management, New York, NY USA

[3] Paracelsus Med Private Univ, Dept Anesthesiol Perioperat Med & Intens Care Med, Salzburg, Austria

[4] VA Palo Alto Hlth Care Syst, Anesthesiol & Perioperat Care Serv, Palo Alto, CA USA

[5] Stanford Univ, Sch Med, Dept Anesthesiol Perioperat & Pain Med, Stanford, CA 94305 USA

[6] Mayo Clin, Dept Anesthesiol & Perioperat Med, Rochester, MN USA

[7] Oxford Univ Hosp NHS Fdn Trust, Nuffield Dept Anaesthet, Oxford, England

[8] Aretaie Univ Hosp, Fac Med, Athens, Greece

[9] Oregon Hlth & Sci Univ, Dept Anesthesiol & Perioperat Med, Portland, OR 97201 USA

[10] Balgrist Univ Hosp, Anesthesiol, Zurich, Switzerland

[11] Univ Valencia, Gen Hosp, Anesthesia Crit Care & Multidisciplinary Pain Man, Valencia, Spain

[12] Univ Valencia, Sch Med, Surg Specialties Dept, Anesthesia Unit, Valencia, Spain

[13] Guys & St Thomas NHS Fdn Trust, Anaesthesia, London, England

[14] Univ Penn, Anesthesiol & Crit Care, Philadelphia, PA 19104 USA

[15] Clin St Anne St Remi, Dept Anesthesiol & Resuscitat, Brussels, Belgium

[16] Hosp Special Surg, Dept Orthoped Surg, 535 E 70th St, New York, NY 10021 USA

[17] Weill Cornell Med Coll, Dept Orthoped Surg, New York, NY USA

[18] Peking Univ, Shougang Hosp, Dept Anesthesiol, Beijing, Peoples R China

[19] Belfast Hlth & Social Care Trust, Dept Anaesthesia, Belfast, Antrim, North Ireland

[20] Rigshosp, Dept Clin Med, Copenhagen, Denmark

[21] Univ Hosp Frankfurt, Anaesthesiol Intens Care Med & Pain Therapy, Frankfurt, Germany

[22] Univ Catholic Louvain, St Luc Hosp, Anesthesiol, Brussels, Belgium

[23] Glasgow Royal Infirm, Sch Med Dent & Nursing, Glasgow, Lanark, Scotland

[24] Stobhill Ambulatory Hosp, Glasgow, Lanark, Scotland

[25] Hosp Special Surg, Ctr Advancement Value Musculoskeletal Care, 535 E 70th St, New York, NY 10021 USA

[26] Weill Cornell Med Coll, Ctr Advancement Value Musculoskeletal Care, New York, NY USA

[27] Ottawa Hosp, Dept Anesthesiol & Pain Med, Ottawa, ON, Canada

[28] Virginia Mason Med Ctr, Anesthesiol, Seattle, WA 98101 USA

[29] Virginia Mason Med Ctr, Benaroya Res Inst, Seattle, WA 98101 USA

[30] Hosp Special Surg, Orthoped Surg, 535 E 70th St, New York, NY 10021 USA

[31] Rothman Orthopaed Inst, Orthoped Surg, Philadelphia, PA USA

[32] Univ Hlth Network, Toronto Western Hosp, Anesthesia, Toronto, ON, Canada

[33] Icahn Sch Med Mt Sinai, Orthopaed Populat Hlth Sci & Policy, New York, NY 10029 USA

[34] New York Langone Orthopaed Hosp, Dept Orthopaed Surg, New York, NY USA

[35] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Dept Anesthesiol, Philadelphia, PA 19107 USA

[36] Dartmouth Med Sch, Anesthesiol, Hanover, NH USA

[37] Med Univ Innsbruck, Dept Anesthesiol & Intens Care, Innsbruck, Austria

[38] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Dept Anesthesiol, Philadelphia, PA 19107 USA

[39] Univ Illinois Hosp & Hlth Sci Syst, Dept Anesthesiol, Chicago, IL USA

来源：

REGIONAL ANESTHESIA AND PAIN MEDICINE | 2021年 / 46卷 / 11期

关键词：

LOCAL INFILTRATION ANALGESIA; ADDUCTOR CANAL BLOCK; POSTOPERATIVE PAIN MANAGEMENT; CONTROLLED EPIDURAL ANALGESIA; LUMBAR PLEXUS BLOCK; RANDOMIZED CONTROLLED-TRIAL; ILIACA COMPARTMENT BLOCK; FEMORAL NERVE; PERIARTICULAR INJECTION; REGIONAL ANESTHESIA;

D O I：

10.1136/rapm-2021-102750

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background Evidence-based international expert consensus regarding the impact of peripheral nerve block (PNB) use in total hip/knee arthroplasty surgery. Methods A systematic review and meta-analysis: randomized controlled and observational studies investigating the impact of PNB utilization on major complications, including mortality, cardiac, pulmonary, gastrointestinal, renal, thromboembolic, neurologic, infectious, and bleeding complications. Medline, PubMed, Embase, and Cochrane Library including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, were queried from 1946 to August 4, 2020. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess evidence quality and for the development of recommendations. Results Analysis of 122 studies revealed that PNB use (compared with no use) was associated with lower ORs for (OR with 95% CIs) for numerous complications (total hip and knee arthroplasties (THA/TKA), respectively): cognitive dysfunction (OR 0.30, 95% CI 0.17 to 0.53/OR 0.52, 95% CI 0.34 to 0.80), respiratory failure (OR 0.36, 95% CI 0.17 to 0.74/OR 0.37, 95% CI 0.18 to 0.75), cardiac complications (OR 0.84, 95% CI 0.76 to 0.93/OR 0.83, 95% CI 0.79 to 0.86), surgical site infections (OR 0.55 95% CI 0.47 to 0.64/OR 0.86 95% CI 0.80 to 0.91), thromboembolism (OR 0.74, 95% CI 0.58 to 0.96/OR 0.90, 95% CI 0.84 to 0.96) and blood transfusion (OR 0.84, 95% CI 0.83 to 0.86/OR 0.91, 95% CI 0.90 to 0.92). Conclusions Based on the current body of evidence, the consensus group recommends PNB use in THA/TKA for improved outcomes. Recommendation: PNB use is recommended for patients undergoing THA and TKA except when contraindications preclude their use. Furthermore, the alignment of provider skills and practice location resources needs to be ensured. Evidence level: moderate; recommendation: strong.

引用

页码：971 / 985

页数：15

共 12 条

[1] Anaesthetic care or patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) based on a systematic review and meta-analysis
Memtsoudis, Stavros G.
Cozowicz, Crispiana
Bekeris, Janis
Bekere, Dace
Liu, Jiabin
Soffin, Ellen M.
Mariano, Edward R.
Johnson, Rebecca L.
Hargett, Mary J.
Lee, Bradley H.
Wendel, Pamela
Brouillette, Mark
Go, George
Kim, Sang J.
Baaklini, Lila
Wetmore, Douglas
Hong, Genewoo
Goto, Rie
Jivanelli, Bridget
Argyra, Eriphyli
Barrington, Michael J.
Borgeat, Alain
De Andres, Jose
Elkassabany, Nabil M.
Gautier, Philippe E.
Gerner, Peter
Della Valle, Alejandro Gonzalez
Goytizolo, Enrique
Kessler, Paul
Kopp, Sandra L.
Homme, Patricia Lavand '
MacLean, Catherine H.
Mantilla, Carlos B.
MacIsaac, Daniel
McLawhorn, Alexander
Neal, Joseph M.
Parks, Michael
Parvizi, Javad
Pichler, Lukas
Poeran, Jashvant
Poultsides, Lazaros A.
Sites, Brian D.
Stundner, Otto
Sun, Eric C.
Viscusi, Eugene R.
Votta-Velis, Effrossyni G.
Wu, Christopher L.
Deau, Jacques T. Ya
Sharrock, Nigel E.
BRITISH JOURNAL OF ANAESTHESIA, 2019, 123 (03) : 269 - 287
[2] The effects of local infiltration anesthesia and femoral nerve block analgesia after total knee arthroplasty: a systematic review and meta-analysis
Liu, Qiang
Wang, Anli
Zhang, Jixia
ANNALS OF TRANSLATIONAL MEDICINE, 2022, 10 (04)
[3] Comparing perioperative outcomes between regional anesthesia and general anesthesia in patients undergoing hip fracture surgery: a systematic review and meta-analysis
Liu, Song
Chen, Jianan
Shi, Huihong
Li, Jianhong
Zeng, Gang
Liu, Wenzhou
Hu, Wenjun
Li, Shaoguang
Gao, Wenjie
Song, Weidong
Liang, Anjing
Chen, Yanbo
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2024, 71 (06): : 849 - 869
[4] Perioperative outcomes in different anesthesia techniques for patients undergoing hip fracture surgery: a systematic review and meta-analysis
Ma, Bo
Xie, Haibiao
Ling, Huayong
Ma, Wuhua
BMC ANESTHESIOLOGY, 2023, 23 (01)
[5] Perioperative outcomes in different anesthesia techniques for patients undergoing hip fracture surgery: a systematic review and meta-analysis
Bo Ma
Haibiao Xie
Huayong Ling
Wuhua Ma
BMC Anesthesiology, 23
[6] The efficacy of pericapsular nerve group block for postoperative analgesia in patients undergoing hip surgery: A systematic review and meta-analysis of randomized controlled trials
Yu, Liang
Shen, Xiaojuan
Liu, He
FRONTIERS IN MEDICINE, 2023, 10
[7] Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques A systematic review and meta-analysis
Chen, Dong Xu
Yang, Lei
Ding, Lin
Li, Shi Yue
Qi, Ya Na
Li, Qian
MEDICINE, 2019, 98 (49)
[8] Perioperative outcomes following preoperative epidural analgesia and anesthesia in hip fracture patients undergoing surgical repair: A systematic review and meta-analysis
Lee, Susan M.
Choi, Jonathan
Lim, Rachel
ANESTHESIA AND ANALGESIA, 2020, 130 : 327 - 329
[9] The impact of regional versus general anesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: A systematic review and meta-analysis
Bhushan, Sandeep
Huang, Xin
Duan, Yuanqiong
Xiao, Zongwei
INTERNATIONAL JOURNAL OF SURGERY, 2022, 105
[10] A commentary on 'The impact of regional versus general anesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: a systematic review and meta-analysis'
Cai, Yong
Zhang, Yongxian
Zhang, Dawei
INTERNATIONAL JOURNAL OF SURGERY, 2023, 109 (10) : 3205 - 3206

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