title: Local infiltration analgesia versus femoral nerve block in total knee arthroplasty: a meta-analysis.
abstract: BACKGROUND
  Local infiltration analgesia (LIA) and femoral nerve block (FNB) are both used for the pain management after total knee arthroplasty (TKA). Controversy still remains regarding the optimal technique for pain relief in patients undergoing TKA. The purpose of this meta-analysis was to compare the analgesia achieved with LIA and the one from FNB following TKA.
  
  
  OBJECTIVE
  LIA achieves better pain control than FNB in patients with TKA.
  
  
  METHODS
  Databases, including Pubmed, EMBASE, the Cochrane Library and Web of Science were comprehensively searched to identify studies comparing LIA with FNB for patients with TKA. Two reviewers independently selected trials, extracted data, and assessed the methodological qualities of included studies. Data were analyzed by RevMan 5.2.
  
  
  RESULTS
  Nine RCTs involving 782 patients were included. LIA achieved more rapid pain relief (VAS) at 6h postoperatively [SMD6h=-0.92, 95% CI (-1.38, -0.47)] than FNB. There were no significant differences at 24h and 48h [SMD24h=-0.03, 95% CI (-0.46, 0.40); SMD48h=0.28, 95% CI (-0.35, 0.91)], VAS with activity at 24h and 48h [SMD6h=-0.54, 95% CI (-1.62, 0.54); SMD24h=-0.22, 95% CI (-1.41, 0.96); SMD48h=-0.08, 95% CI (-0.52, 0.69)], opioid consumption at 24h and 48h [SMD24h=-0.24, 95% CI (-0.82, 0.34); SMD48h=0.15, 95% CI (0.25, 0.54)] and length of hospital stay [MD=-0.52, 95% CI (-1.13, 0.09)].
  
  
  CONCLUSIONS
  LIA may be the better choice in the pain management of TKA for it could achieve fast pain relief and is easier to perform than FNB for patients with TKA.
  
  
  METHODS
  Level II, meta-analysis and systematic review.
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: X-D
authors.initials: XD
authors.lastname: Yun
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: X-L
authors.initials: XL
authors.lastname: Yin
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: J
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Teng
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: H-T
authors.initials: HT
authors.lastname: Dong
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China.
authors.forename: L-P
authors.initials: LP
authors.lastname: An
authors.affiliation: Department of Orthopaedics, Orthopaedics Key Laboratory of Gansu Province, Second Hospital of Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, PR China. Electronic address: xiayylzu@126.com.
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Xia
mesh_terms: D000765:Anesthesia, Conduction; D019645:Arthroplasty, Replacement, Knee; D005267:Femoral Nerve; D006801:Humans; D007270:Injections, Intra-Articular; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control*
keywords: Femoral nerve block; Local infiltration analgesia; Pain control; Total knee arthroplasty