Femoral nerve blocks for the treatment of acute pre-hospital pain: A systematic review with meta-analysis.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Hyldmo, Per K
Friesgaard, Kristian D
Vist, Gunn E
MetadataShow full item record
CitationRaatiniemi L, Magnusson V, Hyldmo PK, et al. Femoral nerve blocks for the treatment of acute pre-hospital pain: A systematic review with meta-analysis [published online ahead of print, 2020 Apr 9]. Acta Anaesthesiol Scand. 2020;10.1111/aas.13600. doi:10.1111/aas.13600
AbstractBackground: Pain management is one of the most important interventions in the emergency medical services. The femoral nerve block (FNB) is, among other things, indicated for pre- and post-operative pain management for patients with femoral fractures but its role in the pre-hospital setting has not been determined. The aim of this review was to assess the effect and safety of the FNB in comparison to other forms of analgesia (or no treatment) for managing acute lower extremity pain in adult patients in the pre-hospital setting. Methods: A systematic review (PROSPERO registration (CRD42018114399)) was conducted. The Cochrane and GRADE methods were used to assess outcomes. Two authors independently reviewed each study for eligibility, extracted the data and performed risk of bias assessments. Results: Four studies with a total of 252 patients were included. Two RCTs (114 patients) showed that FNB may reduce pain more effectively than metamizole (mean difference 32 mm on a 100 mm VAS (95% CI 24 to 40)). One RCT (48 patients) compared the FNB with lidocaine and magnesium sulphate to FNB with lidocaine alone and was only included here for information regarding adverse effects. One case series included 90 patients. Few adverse events were reported in the included studies. The certainty of evidence was very low. We found no studies comparing FNB to inhaled analgesics, opioids or ketamine. Conclusions: Evidence regarding the effectiveness and adverse effects of pre-hospital FNB is limited. Studies comparing pre-hospital FNB to inhaled analgesics, opioids or ketamine are lacking.
DescriptionOulu University Hospital
Rights© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
- Nerve blocks for initial pain management of femoral fractures in children.
- Authors: Black KJ, Bevan CA, Murphy NG, Howard JJ
- Issue date: 2013 Dec 17
- Femoral nerve blocks for acute postoperative pain after knee replacement surgery.
- Authors: Chan EY, Fransen M, Parker DA, Assam PN, Chua N
- Issue date: 2014 May 13
- A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial.
- Authors: Beaudoin FL, Haran JP, Liebmann O
- Issue date: 2013 Jun
- Pre-operative femoral nerve block for hip fracture-A systematic review with meta-analysis.
- Authors: Skjold C, Møller AM, Wildgaard K
- Issue date: 2020 Jan
- The role of sciatic nerve block to complement femoral nerve block in total knee arthroplasty: a meta-analysis of randomized controlled trials.
- Authors: Zorrilla-Vaca A, Li J
- Issue date: 2018 Jun