Risk of bias for analysis 1.1 Pain on movement within 30 minutes of block placement.
| Study | Bias | |||||||||||
| Randomisation process | Deviations from intended interventions | Missing outcome data | Measurement of the outcome | Selection of the reported results | Overall | |||||||
| Authors' judgement | Support for judgement | Authors' judgement | Support for judgement | Authors' judgement | Support for judgement | Authors' judgement | Support for judgement | Authors' judgement | Support for judgement | Authors' judgement | Support for judgement | |
| Subgroup 1.1.1 Fascia iliaca compartment block | ||||||||||||
| Albrecht 2014 | Low risk of bias | Randomly allocated according to a computer‐generated list of random numbers and allocation concealed in sealed opaque envelopes. Intervention group had lower pain score at baseline. This difference was judged as compatible with what could be expected from chance alone in a study with a sample size. | Low risk of bias | No deviations from intended interventions identified | Low risk of bias | 100% of included participants were analyzed | Low risk of bias | Pain scores collected by a nurse blinded to the intervention group | High risk of bias | Study authors elected to deviate from the planned statistical analysis after knowing the results. | High risk of bias | This trial was judged as at high risk of bias for this outcome due to the fact that study authors elected to deviate from the planned statistical analysis after knowing the results. |
| Diakomi 2014 | Low risk of bias | Patients were randomly assigned, using a sealed envelope method and there was no baseline differences between intervention groups. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | 98% of included participants were analysed | Low risk of bias | Pain scores collected by an anaesthesiologist blinded to the intervention group. | Low risk of bias | No deviation to the planned statistical analysis reported. Only one result provided for the time point selected by review authors. |
Low risk of bias | No risk of bias identified |
| Domac 2015 | Low risk of bias | Patients included in the study were divided into two equal groups for this prospective double‐blind study. No difference between intervention groups at baseline identified. | Low risk of bias | No deviations from intended interventions identified | Low risk of bias | 100% of included participants were analyzed. | Low risk of bias | Pain scores probably collected by an assessor blinded to the intervention group. | Low risk of bias | No deviation to the statistical analysis reported. Only one result provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Foss 2005a | Low risk of bias | The randomization was done via a computer‐generated list. Pain at rest before intervention was higher in the intervention group (P = 0.04). The imbalance can be compatible with the one expected due to chance alone in a study with a small sample size. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | One patient did not have a fracture but only a severe contusion and was excluded after x‐ray; an extra patient was therefore included on a new number. 98% of included participants were analyzed |
Low risk of bias | Pain scores collected by an assessor blinded to the intervention group. | Low risk of bias | No deviation from the plan analysis identified. Only one result provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Hogg 2009 | Low risk of bias | Prospective, randomised controlled trial and no baseline differences between intervention groups identified. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | 98% of included participants were analysed. | Low risk of bias | Pain scores. Although this is a subjective score, the fact that a correlation between the effect size and the local anaesthetic drug concentration was found in the review (meta‐regression P value = 0.0003) seems to indicate that scores were valid indicators of pain on movement. | Low risk of bias | No deviation to the statistical analysis reported. Only one result provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Landsting 2008 | Low risk of bias | Randomization was carried out using a computer, and information about the study intervention was sealed in envelopes. No baseline differences between intervention groups identified. | Low risk of bias | No deviations from intended interventions identified. | High risk of bias | Only 56% of included participants had data available for the time point selected by review authors. We were unable to determine if missingness was related to the outcome or not. We therefore deemed it prudent to judge this trial at high risk of bias for this domain for this outcome. | Low risk of bias | Pain scores derived from a combination of self‐rating scales collected by a blinded assessor. | Low risk of bias | No deviation to the statistical analysis reported. Only one result provided for the time point selected by review authors. | High risk of bias | Judged as at high risk of bias for this outcome due to high number of missing data at the time point selected by review authors and uncertainty as to whether or not missingness could be related to this outcome. |
| Yun 2009 | Low risk of bias | Randomly assigned using an allocation sequence generated by a computer, and allocation sequence concealed in envelopes until group was assigned. No baseline differences between intervention groups identified. | Low risk of bias | No deviations form intended interventions identified. | Low risk of bias | 100% of included participants analyzed. | Low risk of bias | Pain scores collected by an assessor probably blinded to te intervention group. | Low risk of bias | No deviations from the planned statistical analysis identified and only one result provided for the time point selected by the review authors. | Low risk of bias | No risk of bias identified |
| Subgroup 1.1.2 Femoral nerve block | ||||||||||||
| Gille 2006 | Low risk of bias | Randomization in two groups by the anaesthesiologist. No baseline differences between intervention groups identified. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | 100% of included participants were analyzed. | Low risk of bias | Pain scores. This is a subjective score but the fact that a correlation between the effect size and the local anaesthetic drug concentration was found by the review authors (meta‐regression P value = 0.0003) seems to indicate that scores were valid indicators of pain on movement. | Low risk of bias | No deviation to the planned statistical analysis reported, only one results provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Murgue 2006 | Low risk of bias | Randomized by “tirage au sort (translated as "hat drawing) ” and no baseline differences between intervention groups identified. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | 94% of included participants were analyzed. | Low risk of bias | Pain scores. This is a subjective score but the fact that a correlation between the effect size and the local anaesthetic drug concentration was found by the review authors (meta‐regression P value = 0.0003) seems to indicate that scores were valid indicators of pain on movement. | Low risk of bias | No deviation to the planned statistical analysis reported. Only one result provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Ranjit 2016 | Low risk of bias | Selected patients were randomized by sealed envelope technique and no baseline differences between intervention groups were identified. | Low risk of bias | No deviations from the intended interventions were identified. | Low risk of bias | 100% of included participants were analyzed. | Low risk of bias | Pain scores. This is a subjective score but the fact that a correlation between the effect size and the local anaesthetic drug concentration was found by the review authors (meta‐regression P value = 0.0003) seems to indicate that scores were valid indicators of pain on movement. | Low risk of bias | No deviation to the planned statistical analysis reported. Only one result provided for the time point selected by review authors. | Low risk of bias | No risk of bias identified |
| Szucs 2010 | Low risk of bias | Randomized using a random number sequence and sealed envelopes. No baseline differences between intervention groups identified. | Low risk of bias | No deviations from intended interventions identified. | Low risk of bias | 89% of included participants were analyzed. | Low risk of bias | Pain scores. This is a subjective score but the fact that a correlation between the effect size and the local anaesthetic drug concentration was found by the review authors (meta‐regression P value = 0.0003) seems to indicate that scores were valid indicators of pain on movement. | Low risk of bias | No deviations from the planned statistical analysis identified and only one result provided for the time point selected by the review authors. | Low risk of bias | No risk of bias identified |