Hunt 2009.
Methods | Randomized trial: Web‐based random number generator | |
Participants | Single centre from Salt Lake City, Utah, USA 57 participants TKR for degenerative joint disease Exclusion criteria: allergy to local anaesthetics, inability to use a PCA pump, history of opioid dependence, severe liver disease, renal insufficiency, bilateral procedure and contraindication to non‐steroidal anti‐inflammatory drugs Mean age (years): 69 ± 7 Female: 67% Number excluded post randomization: none Number lost to follow‐up: none |
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Interventions | 1. Single‐shot FNB with 10 to 15 ml 0.5% bupivacaine. Nerve identified via nerve stimulation. IV PCA morphine 1 mg to 2 mg every 10 minutes (lockout 10 minutes) with maximum of 30 mg in four hours 2. IV PCA morphine 1 mg to 2 mg every 10 minutes (lockout 10 minutes) with maximum of 30 mg in four hours until postoperative day two; sham FNB with 10 to 15 ml saline Adjunct analgesics: standard dose of vicodin. In cases of allergy, an alternate analgesic was used |
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Outcomes | Pain severity at rest: visual analogue scale at day of surgery, postoperative days one and two Total opioid consumption: postoperative days one and two |
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Notes | Single‐shot FNB + sciatic group excluded from data extraction, as it was a non‐random arm. Study author provided additional information on method of randomization, allocation concealment, persons blinded and co‐analgesics used | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Web‐based random number generator (study author provided information) |
Allocation concealment (selection bias) | Low risk | Sealed envelopes (study author provided information) |
Blinding of participants and personnel (performance bias) Subjective outcomes | Low risk | Participants and surgeon blinded (study author provided information) |
Blinding of outcome assessment (detection bias) Subjective outcomes | Low risk | Ward nurses blinded to treatment groups |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No dropouts/withdrawals |
Selective reporting (reporting bias) | Low risk | Outcomes predefined |
Other bias | Low risk | Appears to be free of other sources of bias |