The efficacy and safety of ankle blocks for foot and ankle surgery : A systematic review with meta-analysis and trial sequential analysis
Copyright © 2024 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Peripheral nerve blocks may be essential elements in a multimodal pain management regime following foot and ankle surgery. We assessed the effects of ankle blocks compared with no intervention/sham block or a sciatic nerve block in patients undergoing surgery of the foot or ankle.
METHODS: We searched CENTRAL, Medline, and Embase for randomised clinical trials comparing ankle block with no intervention/sham block or a sciatic nerve block for patients undergoing surgery of the foot or ankle. Our primary outcomes were duration of analgesia and cumulative 24-hour opioid consumption. We followed the recommendations of the Cochrane Handbook, and performed meta-analysis, Trial Sequential Analysis (TSA), and assessed the risk of bias and certainty of the evidence using the GRADE approach.
RESULTS: We included five trials (362 participants) comparing ankle block with no intervention/sham block and three trials (247 participants) comparing ankle block with a sciatic nerve block. Ankle block may increase the duration of analgesia when compared with no intervention/sham block (MD 431 min; 96.7% CI 208 to 654), but the evidence was very uncertain. Duration was decreased when compared with a sciatic nerve block (MD -410 min; 96.7% CI -462 to -358). The ankle block duration was probably important in both comparisons. The effects on cumulative 24-hour opioid consumption were very uncertain in both comparisons.
CONCLUSIONS: Ankle block may increase the duration of analgesia when compared with no intervention/sham block, but the evidence was very uncertain, and decrease the duration of analgesia when compared with a sciatic nerve block. The ankle block duration was probably clinically important in both comparisons. The effects on cumulative 24-hour opioid consumption were very uncertain.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons - (2024) vom: 07. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schou, Nikolaj K [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesia |
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| Anmerkungen: |
Date Revised 16.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.fas.2024.02.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369826809 |
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| 100 | 1 | |a Schou, Nikolaj K |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The efficacy and safety of ankle blocks for foot and ankle surgery |b A systematic review with meta-analysis and trial sequential analysis |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 16.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Peripheral nerve blocks may be essential elements in a multimodal pain management regime following foot and ankle surgery. We assessed the effects of ankle blocks compared with no intervention/sham block or a sciatic nerve block in patients undergoing surgery of the foot or ankle | ||
| 520 | |a METHODS: We searched CENTRAL, Medline, and Embase for randomised clinical trials comparing ankle block with no intervention/sham block or a sciatic nerve block for patients undergoing surgery of the foot or ankle. Our primary outcomes were duration of analgesia and cumulative 24-hour opioid consumption. We followed the recommendations of the Cochrane Handbook, and performed meta-analysis, Trial Sequential Analysis (TSA), and assessed the risk of bias and certainty of the evidence using the GRADE approach | ||
| 520 | |a RESULTS: We included five trials (362 participants) comparing ankle block with no intervention/sham block and three trials (247 participants) comparing ankle block with a sciatic nerve block. Ankle block may increase the duration of analgesia when compared with no intervention/sham block (MD 431 min; 96.7% CI 208 to 654), but the evidence was very uncertain. Duration was decreased when compared with a sciatic nerve block (MD -410 min; 96.7% CI -462 to -358). The ankle block duration was probably important in both comparisons. The effects on cumulative 24-hour opioid consumption were very uncertain in both comparisons | ||
| 520 | |a CONCLUSIONS: Ankle block may increase the duration of analgesia when compared with no intervention/sham block, but the evidence was very uncertain, and decrease the duration of analgesia when compared with a sciatic nerve block. The ankle block duration was probably clinically important in both comparisons. The effects on cumulative 24-hour opioid consumption were very uncertain | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Analgesia | |
| 650 | 4 | |a Evidence synthesis | |
| 650 | 4 | |a Pain management | |
| 650 | 4 | |a Peripheral nerve block | |
| 650 | 4 | |a Regional anaesthesia | |
| 700 | 1 | |a Svensson, Lisa G T |e verfasserin |4 aut | |
| 700 | 1 | |a Cleemann, Rasmus |e verfasserin |4 aut | |
| 700 | 1 | |a Andersen, Jakob H |e verfasserin |4 aut | |
| 700 | 1 | |a Mathiesen, Ole |e verfasserin |4 aut | |
| 700 | 1 | |a Maagaard, Mathias |e verfasserin |4 aut | |
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