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2022, Vol. 26 ›› Issue (2): 315-320Analgesic effect of adductor canal block versus femoral nerve block after autogenous bone-tendon-bone reconstruction of the anterior cruciate ligament: an updated Meta-analysisDiao Yulei, Zong Xiaorui, Deng Zhibo, Shu Han
Abstract: OBJECTIVE: Adductor canal block and femoral nerve block are common analgesic methods after anterior cruciate ligament reconstruction. This article systematically evaluates the analgesic effect of adductor tube block and femoral nerve block after anterior cruciate ligament reconstruction with autogenous bone-tendon-bone reconstruction. METHODS: A computer-based search was performed in PubMed, EMbase, Cochrane Library, Web of Science, Google Scholar, CNKI, WanFang, VIP and CBM databases for clinical randomized controlled trials on the analgesic effect of femoral nerve block and adductor canal block from the establishment of the database to October 31, 2020 A randomized controlled clinical trial in analgesia after ligament reconstruction. The Cochrane risk bias table was used to assess the quality of the included literature. Meta-analysis was performed with RevMan 5.3 software, and the evaluation indicators included the main visual analog scale scores, opioid consumption and complications. RESULTS: A total of 6 randomized controlled trials involving 506 patients were included, 251 patients in the control group received femoral nerve block, and 255 patients in the intervention group received adductor tube block. The quality of the literature was higher. Meta-analysis showed that compared with the control group, the intervention group only had a slight advantage in reducing the visual analog scale score at 48 hours after surgery (mean difference=0.65, 95% confidence interval: 0.10-1.20, P < 0.05), but there was no significant difference between the two groups in terms of visual analog scores at 0, 6, 12, 18, and 24 hours postoperatively and morphine consumption at 0, 24, and 48 hours postoperatively (P > 0.05). Fewer complications, such as deep vein thrombosis, re-rupture of the anterior cruciate ligament, pain in the anterior knee area, defective knee extension function, decreased quadriceps muscle strength, and risk of falling, occurred in both two groups, indicating a high safety of two methods. CONCLUSION: There is basically no significant difference between femoral nerve block and adductor canal block in terms of postoperative analgesia, but large-sample randomized controlled trials are needed in the future to confirm the results. Adductor canal block is recommended in clinical practice due to its small inhibitory effects on the muscle strength of quadriceps muscle and no obvious complications. Key words:soft tissue, anterior cruciate ligament, adductor canal, repair, block, saphenous nerve, femoral nerve, pain, Meta-analysis |