膝关节骨关节炎的膝神经阻滞：随机临床试验的系统回顾与荟萃分析》。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY Clinical Journal of Pain Pub Date : 2024-10-01 DOI:10.1097/AJP.0000000000001240

Félix Vilchez-Cavazos, Augusto A Gamboa Alonso, Mario Simental-Mendía, Víctor M Peña-Martínez, Carlos A Acosta-Olivo, Gregorio A Villarreal-Villarreal

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引用次数: 0

摘要

目的：膝关节神经阻滞（GNB）已成为治疗无症状膝关节骨性关节炎（OA）的新型非手术疗法。目的是评估膝关节神经阻滞与安慰剂和其他关节内（IA）疗法的比较：方法：在 Medline、Embase 和 Scopus 数据库中检索了从开始到 2021 年 1 月的所有研究。只纳入了随机对照试验（RCT）。采用随机效应模型和通用逆方差法进行定量数据综合。用 I2 指数检验了异质性：在疼痛方面，1个月和3个月的总有效率为1.43 [95% CI, 0.86, 1.99]; P=0.00001; I2=85%）。同样，在膝关节功能方面，1 个月和 3 个月时的总效果为 0.71 [95% CI, 0.35, 1.06]；P=0.00001；I2=69%），具有统计学意义。1个月和3个月后，疼痛方面的临床重要差异达到最小：尽管如此，GNB 在膝关节 OA 疼痛方面达到了最小临床意义差异，在膝关节功能方面也有统计学意义。由于研究的异质性和有限的随访，GNB治疗原发性膝关节OA的证据尚不充分。

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Genicular Nerve Block for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

Objectives: Genicular nerve block (GNB) has emerged as a novel nonsurgical therapy for symptomatic knee osteoarthritis (KOA). The objective was to evaluate GNB versus placebo and other intra-articular (IA) therapies.

Methods: The Medline, Embase, and Scopus databases were searched from their inception to January 2021. Only randomized controlled trials (RCTs) were included. A random-effects model and the generic inverse variance method were used for quantitative data synthesis. Heterogeneity was tested with the I2 index.

Results: Regarding pain statistically significant scores were demonstrated at 1 and 3 months overall total effect of 1.43 (95% CI, 0.86, 1.99; P= 0.00001; I2 =85%). Similarly, for knee function a total effect of 0.71 (95% CI, 0.35, 1.06; P= 0.00001; I2 =69%) at 1 and 3 months, statistically significant. The minimal clinically important difference regarding pain was achieved at 1 and 3 months.

Discussion: Although, GNB achieved the MCID for KOA pain and statistically significant results for knee functions. We cannot recommend its routine use besides being a safe procedure so far, evidence is fair on GNB for primary KOA due to study heterogeneity and limited follow-up.

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来源期刊

Clinical Journal of Pain 医学-临床神经学

CiteScore

5.40

自引率

3.40%

发文量

118

审稿时长

4-8 weeks

期刊介绍： The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.