The efficacy and safety of ankle blocks for foot and ankle surgery: A systematic review with meta-analysis and trial sequential analysis
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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The efficacy and safety of ankle blocks for foot and ankle surgery : A systematic review with meta-analysis and trial sequential analysis. / Schou, Nikolaj K.; Svensson, Lisa G. T.; Cleemann, Rasmus; Andersen, Jakob H.; Mathiesen, Ole; Maagaard, Mathias.
I: Foot and Ankle Surgery, Bind 30, Nr. 5, 2024, s. 355-365.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - The efficacy and safety of ankle blocks for foot and ankle surgery
T2 - A systematic review with meta-analysis and trial sequential analysis
AU - Schou, Nikolaj K.
AU - Svensson, Lisa G. T.
AU - Cleemann, Rasmus
AU - Andersen, Jakob H.
AU - Mathiesen, Ole
AU - Maagaard, Mathias
N1 - Publisher Copyright: © 2024 European Foot and Ankle Society
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Analgesia
KW - Evidence synthesis
KW - Pain management
KW - Peripheral nerve block
KW - Regional anaesthesia
U2 - 10.1016/j.fas.2024.02.015
DO - 10.1016/j.fas.2024.02.015
M3 - Review
C2 - 38492998
AN - SCOPUS:85187978965
VL - 30
SP - 355
EP - 365
JO - Foot and Ankle Surgery
JF - Foot and Ankle Surgery
SN - 1268-7731
IS - 5
ER -
ID: 388779950