Background: This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between\nlocal infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after\ntotal knee arthroplasty (TKA).\nMethods: A systematic search was performed in MEDLINE (1966-2017.04), PubMed (1966-2017.04), Embase\n(1980-2017.04), ScienceDirect (1985-2017.04), and the Cochrane Library. Only high-quality studies were selected.\nMeta-analysis was performed using Stata 11.0 software.\nResults: Four randomized controlled trials (RCTs) and two non-randomized controlled trials (non-RCTs), including 273\npatients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between\ngroups in terms of visual analogue scale (VAS) score at 12 h (SMD = âË?â??0.303, 95% CI âË?â??0.543 to âË?â??0.064, P = 0.013),\nVAS score at 24 h (SMD = âË?â??0.395, 95% CI âË?â??0.636 to âË?â??0.154, P = 0.001), morphine equivalent consumption at 24 h\n(SMD = âË?â??0.395, 95% CI âË?â??0.636 to âË?â??0.154, P = 0.001), and incidence of nausea (RD = 0.233, 95% CI 0.107 to 0.360,\nP = 0.000) and vomiting (RD = 0.131, 95% CI 0.025 to 0.237, P = 0.015).\nConclusion: FNB-combined SNB provides superior pain relief and less morphine consumption within the first\n24 h compared FNB-combined LIA in total knee arthroplasty. In addition, there were fewer side effects associated\nwith SNB. Because the sample size and the number of included studies were limited, a multicenter RCT is needed\nto identify the effects of the two kinds of methods and further work must include range of motion analyses and\nfunctional test.
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