The Comparison of Pain Relief and Adverse Events Between Continuous Femoral Nerve Block and Single-shot Adductor Canal Block for Total Knee Arthroplasty

Objective: The objective of this systematic review and meta-analysis was to compare pain relief and adverse events between continuous femoral nerve block (CFNB) and single-shot adductor canal block (SACB) techniques for total knee arthroplasty (TKA).

Design: A comprehensive literature search was conducted in multiple databases to identify relevant studies comparing CFNB and SACB in TKA patients. Randomized controlled trials and cohort studies were included in the review.

Setting: Clinics, hospitals, and surgical centers.

Participants: Patients who underwent TKA. Both male and female patients of different age groups were considered.

Interventions: The interventions of interest were CFNB and SACB techniques for postoperative pain management in TKA.

Main Outcome Measures: Pain relief was the primary outcome measure. This was assessed using the visual analog score and opioid consumption. Adverse events, including motor weakness, falls, nerve injury, and other complications, were also assessed.

Results: Twelve studies, comprising randomized controlled trials and cohort studies, were included in the analysis. The meta-analysis demonstrated that CFNB provided superior pain relief compared to SACB, with a significantly lower pain score (pooled effect size -0.61, 95% confidence interval -0.91 to -0.30) and reduced opioid consumption (pooled effect size -0.47, 95% confidence interval -0.86 to -0.07). There was no significant difference in the occurrence of adverse events between the two techniques (pooled effect size 0.03, 95% confidence interval -0.36 to 0.43).

Conclusions: Both CFNB and SACB techniques are effective in providing pain relief for patients undergoing TKA. CFNB demonstrated superior pain relief and reduced opioid consumption compared to SACB. The occurrence of adverse events was similar between the two techniques. Clinicians should consider these findings when selecting the most appropriate technique for postoperative pain management in TKA.