Table 1.
Summary of measurement timings of pain outcomes utilised in included studies.
| Author/year | Country of study | Measurement tool | Time measured | Nerve block |
|---|---|---|---|---|
| Ambrosoli et al. [12] | Not stated | NRS (not stated; 0–10) | 4 hours post-op | Sciatic nerve catheter |
| Upon discharge | ||||
| NRS at rest (0–10) | 24 hours | |||
| 48 hours | ||||
| NRS on activity (0–10) | 24 hours | |||
| 48 hours | ||||
| Number of occasions sleep was disturbed by pain | 24 hours | |||
| 48 hours | ||||
|
| ||||
| Andersen et al. [13] | Denmark | Worst pain during knee movement | On day of surgery | Saphenous nerve block |
| VAS (10 cm) at rest | ||||
| Time from surgery to VAS score 3 (not stated) | Hours | |||
| Sleep disturbance due to pain (yes/no) | D1 post-op | |||
| D2 post-op | ||||
| D3 post-op | ||||
| Total opioid consumption | 48 hours | |||
|
| ||||
| Bengisun et al. [39] | Turkey | VAS (10 cm; not stated) | 2 hours post-op | Interscalene block |
| 4 hours post-op | ||||
| 6 hours post-op | ||||
| 12 hours post-op | ||||
| 24 hours post-op | ||||
|
| ||||
| Bharti et al. [14] | India | VAS (10 cm; not stated) | Every 30 min for 2 hours | Supraclavicular brachial plexus block |
| Every 1 hour for 6 hours | ||||
| Every 2 hours for 12 hours | ||||
| 24 hours post-op | ||||
| Total analgesic requirement (opiate and nonopiate) | 24 hours post-op | |||
|
| ||||
| Boussofara et al. [15] | Tunisia | VAS (10 cm; not stated) | Every 15 min post-op whilst in PACU | Spinal anaesthetic block |
| Total opioid consumption | Whilst in PACU | |||
|
| ||||
| Capdevilla et al. [16] | France | VAS (10 cm; not stated) | 10 min post-op | Interscalene and popliteal infusions |
| 1 hour post-op | ||||
| 4 hours post-op | ||||
| 12 hours post-op | ||||
| AM D1 post-op during physiotx | ||||
| AM D2 post-op during physiotx | ||||
| AM D3 post-op during physiotx | ||||
| AM D4 post-op during physiotx | ||||
| Total analgesic consumption (nonopiate) | Over 72 hours | |||
|
| ||||
| Choi et al. [17] | Canada | NRS on activity (0–10) | AM D2 post-op | Femoral nerve block continuous versus single |
| Total opioid consumption | 48 hours | |||
| NRS at rest (0–10) | AM D1 post-op | |||
| NRS on activity (0–10) | D1 post-op | |||
| Worst NRS (0–10) | D1 post-op | |||
| NRS (0–10; not stated) | 4.5 months post-op | |||
|
| ||||
| Diakomi et al. [18] | Greece | Time to first IV opioid request (hours) | No. of hours | Fascia iliaca block |
| Total opioid consumption | Over first 24 hours | |||
|
| ||||
| Elkassabany et al. [19] | USA | Pain scores (type of pain score not stated) | Before physiotherapy | Femoral nerve block versus adductor canal block |
| Pain scores (type of pain score not stated) | After physiotherapy | |||
| Pain scores (APS-POQ-R) | At 24 hours | |||
| Total opioid consumption | AM D1 post-op | |||
| AM D2 post-op | ||||
|
| ||||
| Fredrickson et al. [20] | New Zealand | NRS (not stated; 0–10) | Emergence | Interscalene catheters |
| Worst in 24 hours on movement | ||||
| Worst in 24 hours at rest | ||||
| Worst in second 24 hours on movement | ||||
| Worst in second 24 hours at rest | ||||
|
| ||||
| Fritsch et al. [21] | Austria | NRS at rest (0–10) | 4 hours post-op | Interscalene brachial plexus block |
| 6 hours post-op | ||||
| 8 hours post-op | ||||
| 10 hours post-op | ||||
| 12 hours post-op | ||||
| 14 hours post-op | ||||
| NRS on activity (0–10) | 4 hours post-op | |||
| 6 hours post-op | ||||
| 8 hours post-op | ||||
| 10 hours post-op | ||||
| 12 hours post-op | ||||
| 14 hours post-op | ||||
|
| ||||
| Hamdani et al. [38] | Switzerland | Average pain score (NRS; 0–10) (not stated) | Over first 24 hours | Continuous interscalene |
| Average pain score (NRS; 0–10) (not stated) | Over first 48 hours | |||
| Total opioid consumption | Over first 24 hours | |||
| Total opioid consumption | Over first 48 hours | |||
| Maximum pain score (NRS; 0–10) (not stated) | Over first 24 hours | |||
| Maximum pain score (NRS; 0–10) (not stated) | Over first 48 hours | |||
|
| ||||
| Karthikeyan et al. [37] | India | VAS (10 cm) (not stated) | Admission to PACU | Bilateral cervical plexus block |
| 2 hours post-op | ||||
| 4 hours post-op | ||||
| 6 hours post-op | ||||
| 8 hours post-op | ||||
| 16 hours post-op | ||||
| 24 hours post-op | ||||
| Time to first analgesic request | Min | |||
| Total analgesic consumption (opioid consumption) | 24 hours post-op | |||
|
| ||||
| Kim et al. [42] | Republic of Korea | VAS (10 cm; not stated) | 1 hour post-op | Serratus-intercostal plane block and intermediate cervical plexus block versus control |
| 3 hours post-op | ||||
| 6 hours post-op | ||||
| 9 hours post-op | ||||
| 24 hours post-op | ||||
|
| ||||
| Kulhari et al. [36] | Not stated | Time to first rescue analgesia | After administration of block | Pectoral nerve block versus thoracic paravertebral block |
| Total analgesic consumption (opioid consumption) | 24 hours post-op | |||
| VAS (10 cm; not stated) | 0 hours post-op | |||
| 0.5 hours post-op | ||||
| 1 hour post-op | ||||
| 2 hours post-op | ||||
| 4 hours post-op | ||||
| 6 hours post-op | ||||
| 8 hours post-op | ||||
| 12 hours post-op | ||||
| 24 hours post-op | ||||
|
| ||||
| Moura et al. [35] | Brazil | NRS (not stated; 0–10) | T0 (after recovering consciousness) | Femoral nerve block |
| 1 hour post-op | ||||
| 2 hours post-op | ||||
| Total dose of supplementary analgesia (opioid and nonopioid) | First 2 hours | |||
| Time to first analgesic supplementation | ||||
|
| ||||
| Nagafuchi et al. [34] | Japan | NRS (not stated; 0–10) | Exiting operating room | Femoral nerve block-sciatic nerve block versus femoral nerve block-LIA |
| 3 hours post-op | ||||
| 12 hours post-op | ||||
| 24 hours post-op | ||||
| Total dose of diclofenac | ||||
|
| ||||
| Salviz et al. [33] | USA | Time to first pain | Hours | Interscalene brachial plexus block |
| Analgesic consumption (opioid) | D1 post-op | |||
| D2 post-op | ||||
| D3 post-op | ||||
| D4 post-op | ||||
| D5 post-op | ||||
| D6 post-op | ||||
| D7 post-op | ||||
| Maximum NRS (not stated; 0–10) | D1 post-op | |||
| D2 post-op | ||||
| D3 post-op | ||||
| D4 post-op | ||||
| D5 post-op | ||||
| D6 post-op | ||||
| D7 post-op | ||||
|
| ||||
| Sawhney et al. [32] | Canada | NRS on activity (0–10) | D1 post-op | Combined adductor canal block with periarticular infiltration versus adductor canal nerve block |
| NRS at rest and with knee bending (0–10) | D1 post-op | |||
| NRS on activity (0–10) | D2 post-op | |||
| NRS at rest and with knee bending (0–10) | D2 post-op | |||
| Analgesic consumption (opioid and nonopioid) per day | ||||
|
| ||||
| Sato et al. [31] | Japan | VAS (10 cm) at rest | At rest just after surgery | Sciatic and femoral continuous versus single shot |
| 6 hours after surgery | ||||
| AM D1 post-op | ||||
| PM D1 post-op | ||||
| AM D2 post-op | ||||
| PM D2 post-op | ||||
| Morphine consumption | Over first 48 hours | |||
|
| ||||
| Siddiqui et al. [41] | USA | VAS (10 cm) at rest | Every 5 min first hour | Lumbar plexus block |
| 4 hours post-op | ||||
| 8 hours post-op | ||||
| 16 hours post-op | ||||
| 20 hours post-op | ||||
| 24 hours post-op | ||||
| 28 hours post-op | ||||
| 32 hours post-op | ||||
| 36 hours post-op | ||||
|
| ||||
| Sindjelic et al. [30] | Serbia | Time to first analgesic request | Min | Cervical plexus block |
| Total opioid consumption | 24 hours post-op | |||
|
| ||||
| Schoenmakers et al. [29] | Netherlands | Time to first analgesic request | Min | Popliteal continuous |
| NRS at rest (0–10) | Immediately post-op | |||
| 24 hours | ||||
| NRS on activity (0–10) | Immediately post-op | |||
| 24 hours | ||||
|
| ||||
| Subramanyam et al. [28] | Canada | NRS (not stated; 0–10) | 30 min post-op | Supraclavicular brachial plexus block |
| 60 min post-op | ||||
| 90 min post-op | ||||
| Time to first analgesic request | Min | |||
|
| ||||
| Stundner et al. [27] | Austria | NRS at rest (0–10) | Baseline before ISB | Interscalene brachial plexus block |
| Immediately post-op | ||||
| 6 hours post-op worst pain | ||||
| 8 hours post-op worst pain | ||||
| 10 hours post-op worst pain | ||||
| 12 hours post-op worst pain | ||||
| 14 hours post-op worst pain | ||||
| AM D1 post-op worst pain | ||||
| NRS on activity (0–10) | Baseline before ISB | |||
| Immediately post-op | ||||
| 6 hours post-op worst pain | ||||
| 8 hours post-op worst pain | ||||
| 10 hours post-op worst pain | ||||
| 12 hours post-op worst pain | ||||
| 14 hours post-op worst pain | ||||
| AM D1 post-op worst pain | ||||
|
| ||||
| Thybo et al. [26] | Denmark | VAS (10 cm) during 30° hip flexion | 4 hours post-op (T4) at T0 (pts able to move toes but before SAB worn off) | Lateral cutaneous femoral nerve block |
| Pain at rest VAS (10 cm) and during 30° hip flexion | T0 | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T1 (after T0) | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T2 (after T0) | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T4 (after T0) | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T8 (after T0) | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T12 (after T0) | |||
| Pain at rest VAS (10 cm) and during 30° hip flexion | T24 (after T0) | |||
| Cumulative oxycodone consumption | 0–24 hours post-op | |||
|
| ||||
| Wegener et al. [25] | Netherlands | WOMAC score | At rest at 3 months | Sciatic nerve block |
| On mobilising at 3 months | ||||
| At rest 12 months | ||||
| On mobilising at 12 months | ||||
| VAS (10 cm) | At rest 3 months | |||
| On mobilising at 3 months | ||||
| At rest 12 months | ||||
| On mobilising at 12 months | ||||
| Oxford knee score (inc. pain) | ||||
|
| ||||
| Wegener et al. [24] | Netherlands | NRS at rest (0–10) | AM D1 post-op | Sciatic and femoral continuous versus single |
| PM D1 post-op | ||||
| AM D2 post-op | ||||
| PM D2 post-op | ||||
| AM D3 post-op | ||||
| PM D3 post-op | ||||
| NRS on mobilisation (0–10) | AM D1 post-op | |||
| PM D1 post-op | ||||
| AM D2 post-op | ||||
| PM D2 post-op | ||||
| AM D3 post-op | ||||
| PM D3 post-op | ||||
| Total morphine consumption | D0 post-op | |||
| D1 post-op | ||||
| D2 post-op | ||||
| D3 post-op | ||||
|
| ||||
| Wongyingsinn et al. [23] | Canada | NRS at rest (0–10) | 24 hours post-op | Thoracic epidural block |
| 48 hours post-op | ||||
| 72 hours post-op | ||||
| NRS on walking (0–10) | 24 hours post-op | |||
| 48 hours post-op | ||||
| 72 hours post-op | ||||
| NRS on coughing (0–10) | 24 hours post-op | |||
| 48 hours post-op | ||||
| 72 hours post-op | ||||
|
| ||||
| YaDeau et al. [40] | USA | NRS at rest (0–10) | 30 min post-op | Lumbar plexus block |
| 1 hour post-op | ||||
| 2 hours post-op | ||||
| 3 hour post-op | ||||
| 4 hours post-op | ||||
| 24 hours post-op | ||||
| NRS on movement (0–10) | 30 min post-op | |||
| 1 hour post-op | ||||
| 2 hours post-op | ||||
| 3 hour post-op | ||||
| 4 hours post-op | ||||
| 24 hours post-op | ||||
|
| ||||
| Zhai et al. [22] | Not stated | NRS at rest (0–10) | Before block | Interscalene brachial plexus block |
| Right before discharge from PACU | ||||
| 4 hours after block | ||||
| 8 hours after block | ||||
| 24 hours after block | ||||
| Worst NRS (0–10) | 24 hours after block | |||
| Time of first shoulder pain | ||||
D0 post-op = Day 0 postoperatively; D1 post-op = Day 1 postoperatively; D2 post-op = Day 2 postoperatively; D3 post-op = Day 3 postoperatively; D4 post-op = Day 4 postoperatively; D5 post-op = Day 5 postoperatively; D6 post-op = Day 6 postoperatively; D7 post-op = Day 7 postoperatively; min = minutes; NRS = numeric (verbal) rating scale (0 = no pain to 10 = worst imaginable pain); VAS = visual analogue scale (0 mm = no pain to 100 mm = worst imaginable pain); APS-POQ-R = American Pain Society Patient Outcome Questionnaire Revised; WOMAC score = Western Ontario and McMaster Universities Osteoarthritis Index (5 pain questions included) OA specific; Oxford Knee Score 12-item knee questionnaire on pain; for measurement tool, “not stated” = whether pain score recorded at rest or on movement not stated in methods.