• Br J Anaesth · Aug 2022

    Editorial Randomized Controlled Trial

    Critical appraisal of randomised trials assessing regional analgesic interventions for knee arthroplasty: implications for postoperative pain guidelines development.

    • Girish P Joshi, Jesse Stewart, and Henrik Kehlet.
    • Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: girish.joshi@utsouthwestern.edu.
    • Br J Anaesth. 2022 Aug 1; 129 (2): 142144142-144.

    AbstractGuidelines are increasingly being used for clinical decision-making. Such guidelines are usually based on meta-analyses, which are generally derived from RCTs. However, their interpretations are often hindered as they do not always consider current clinical relevance. Analyses of RCTs assessing analgesic efficacy of advanced regional analgesic techniques in knee arthroplasty show that the majority of trials do not include a package of basic analgesics such as paracetamol, NSAIDs or cyclooxygenase-2 specific inhibitors, dexamethasone, and local infiltration analgesia in the comparator group. Consequently, the current approach to analyse meta-analyses of pain interventions is not optimal, and may lead to inadequate or inappropriate conclusions and clinical guidance.Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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