Table 1 Characteristics of included studies
Studies | Participants (n) I/C | Design; Location | Age (mean, SD) I/C | Sex (F, M) I/C | BMI (mean, SD) (kg/m2), I/C | Pre-emptive analgesia | Anaesthesia type and tourniquet status | SACB method and dose | CACB method and dose | Rescue analgesia |
|---|---|---|---|---|---|---|---|---|---|---|
Canbek et al. 2019 | 63 / 60 | SB RCT; Turkey | 66.9, 6.8 / 67.1, 6.9 | 15, 48 / 10, 50 | 31.4, 4.8 / 32.3, 4.3 | Diclofenac sodium 75Â mg or Paracetamol 1Â g (if serum creatinine abnormal) | Spinal with tourniquet | Immediately postop bupivicaine 0.25% 30Â mL | Immediately postop bupivacaine 0.125% 5Â mL/h (total 125Â mL over 24Â h) | Tramadol (50Â mg) |
Elkassabany et al. 2019 | 53 / 51 | NB RCT; USA | 63.9, 9.6 / 66.5, 8.5 | 37, 16 / 29, 22 | 31.5, 5.1 / 31.2, 5.2 | - | Spinal: SACB n = 40 CACB n = 39 With tourniquet | Intraoperative ropivacaine 0.5% 20 mL | Intraoperative ropivacaine 0.5% 17–18 mL bolus + 0.2% 8 mL/hr (24 h) | Oxycodone IV |
Elkassabany et al. 2019 | 53 / 52 | NB RCT; USA | 63.9, 9.6 / 62.2, 8.7 | 37, 16 / 34, 18 | 31.5, 5.1 / 31.9, 4.9 | - | Spinal: SACB n = 40 CACB n = 43 With tourniquet | Intraoperative ropivacaine 0.5% 20 mL | Intraoperative ropivacaine 0.5% 17–18 mL bolus + 0.2% 8 mL/hr (48 h) | Oxycodone IV |
Kim et al. 2019 | 22 / 22 | NB RCT; South Korea | 66.4, 8.8 / 70.1, 10.3 | 2, 20 / 3, 19 | 27.1, 4.1 / 25.5, 3.9 | None given | General with tourniquet | 1 h preoperative ropivacaine 0.5% 20 mL bolus + IV fentanyl 0.4 µg/kg/h | 1 h preoperative ropivacaine 0.5% 5 mL bolus + 0.2% 5 mL/hr | Tramadol (50 mg) |
Lyngeraa et al. 2019 | 49 / 49 | DB RCT; Denmark | 69.7, 8.5 / 70.3, 8.8 | 13, 37 / 21, 30 | 28.7, 4.7 / 28.4, 4.9 | Paracetamol 1 g Celecoxib 400 mg | Spinal with tourniquet | Immediately postop ropivacaine 0.75% 20 mL | Immediately postop ropivicaine 0.75% 20 mL bolus + standard catheter 0.2% 20 mL every 8 h until 12 pm POD2 | Morphine IV |
Lyngeraa et al. 2019 | 49 / 52 | DB RCT; Denmark | 69.7, 8.5 / 70.4, 6.9 | 13, 37 / 21, 31 | 28.7, 4.7 / 28.3, 4.7 | Paracetamol 1 g Celecoxib 400 mg | Spinal with tourniquet | Ropivacaine 0.75% 20 mL | Ropivicaine 0.75% 20 mL bolus + suture-method catheter 0.2% 20 mL every 8 h until 12 pm POD2 | Morphine IV |
Li et al. 2017 | 30 / 30 | NB RCT; China | 67.7, 7.8 / 65.9, 8.4 | 6, 24 / 6, 24 | 24.2, 2.7 / 25.2, 3.2 | Celecoxib 200 mg twice daily for 3 days | General With tourniquet | Ropivacaine 2.5 g/L 30 mL + Adrenaline 0.1 mg | Ropivacaine 2.5 g/L 8 mL/hr + 5 mL (After 48 h and stays for 30 min) | Pethidine hydrochloride (50 mg) |
Shah et al. 2015 | 39 / 46 | DB RCT; India | 66.3, 6.38 / 68.34, 7.71 | 7, 32 / 13, 33 | 30.27, 5.4 / 29.58, 5.55 | Diclofenac sodium 75 mg 8 hourly or Paracetamol 1 g 8 hourly (if serum creatinine abnormal) | Spinal No tourniquet | Ropivacaine 0.75% 30 mL + saline 30 mL 4 h post-op | Ropivacaine 0.75% 30 mL bolus + 0.25% 30 mL every 4 h until 8am POD2 | Tramadol (50 mg) IV |
Turner et al. 2018 | 30 / 30 | DB RCT; USA | 68.8, 10 / 70.9, 7.9 | 21, 9 / 13, 17 | 31.3, 5 / 31.5, 6 | Paracetamol 1 g Pregabalin 150 mg Celecoxib 400 mg | Spinal or general Tourniquet status not reported | Bupivacaine 0.25% + clonidine 1.67 µg/mL + dexamethasone 2 mg + buprenorphine 150 µg + epinephrine 2 µg/mL, for a total 20 mL bolus | Bupivacaine 0.25% + epinephrine 2.5mcg/mL for a total 20 mL bolus + bupivacaine 0.125% 8 mL/h continued through to POD2 | Oxycodone, Hydromorphone IV |
Zhang et al. 2018 | 25 / 23 | DB RCT; China | 65, 8 / 67, 7 | 4, 21 / 5, 18 | 25.96, 3.38 / 26.32, 4.25 | – | – | Ropivicaine 0.5% 20 mL + intermittent saline 12 and 24 h post-operative | Ropivicaine (standard catheter, 0.5%) 20 mL pre-operative + 0.5% 20 mL at 12 h and 24 h post-operative | Pethidine hydrochloride (50 mg) IM |