• Qiujuan Xing, Weiwei Dai, Dongfeng Zhao, Ji Wu, Chunshui Huang, and Yun Zhao.
• aDepartment of Rehabilitation, Tianshan Traditional Chinese Medicine Hospital of Changning District bCentral Laboratory of Science and Technology Department, Longhua Hospital cInstitute of Spine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
• Medicine (Baltimore). 2017 Sep 1; 96 (38): e8103.

BackgroundThis meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA).MethodsPubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TKA. Main outcomes were numeric rating scale (NRS) at postoperative day (POD) 0-2 and opioid consumption. Meta-analysis was performed using Stata 11.0 software.ResultsFour randomized controlled trial (RCTs) including 297 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between the groups regarding NRS score at POD 0 (weighted mean difference [WMD] = -0.849, 95% confidence interval [CI]: -1.345 to -0.353, P = .001), POD 1 (WMD = -0.960, 95% CI: -1.474 to -0.446, P = .000), and POD 2 (WMD = -0.672, 95% CI: -1.163 to -0.181, P = .007) after TKA. Significant differences were found in terms of opioid consumption at POD 0 (WMD = -3.761, 95% CI: -6.192 to -1.329, P = .002), POD 1 (WMD = -4.795, 95% CI: -8.181 to -1.409, P = .006), and POD 2 (WMD = -2.867, 95% CI: -4.907 to -0.827, P = .006).ConclusionCombined adductor canal block with peri-articular infiltration could significantly reduce NRS scores and opioid consumption in comparison with periarticular infiltration alone following TKA. Additionally, there is a lower incidence of nausea and vomiting in the combined groups.

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