International Journal of Clinical Practice

Research Article

Efficacy and Safety of Pericapsular Nerve Group Block for Hip Fracture Surgery under Spinal Anesthesia: A Meta-Analysis

Table 2

Assessment of evidence quality.
Quality assessmentNo of patientsEffectQualityImportance
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther considerationsPENGOther analgesic methodsRelative (95% CI)Absolute
PONV
8RCTSerious1No serious inconsistencyNo serious indirectnessNo serious imprecisionNone13/242 (5.4%)20/242 (8.3%)RR 0.67 (0.34 to 1.32)27 fewer per 1000 (from 55 fewer to 26 more)ÅÅÅO moderateImportant
 9.2%30 fewer per 1000 (from 61 fewer to 29 more)
Decreased muscle strength
5RCTNo serious risk of biasNo serious inconsistencyNo serious indirectnessSerious2None0/134 (0%)9/134 (6.7%)RR 0.11 (0.01 to 0.86)60 fewer per 1000 (from 9 fewer to 66 fewer)ÅÅÅO moderateCritical
 0%—
VAS during positioning (better indicated by lower values)
6RCTSerious1Very serious3No serious indirectnessNo serious imprecisionNone210202—SMD 1.48 lower (2.35 to 0.62 lower)ÅOOO very lowCritical
VAS 6 hour after operation (better indicated by lower values)
5RctNo serious risk of biasNo serious inconsistencyNo serious indirectnessSerious2None127127—SMD 0.08 lower (0.33 lower to 0.17 higher)ÅÅÅO moderateCritical
VAS 12 hour after operation (better indicated by lower values)
5RCTNo serious risk of biasVery serious3No serious indirectnessSerious2None137137—SMD 0.7 lower (1.43 lower to 0.03 higher)ÅOOO very lowCritical
VAS 24 hour after operation (better indicated by lower values)
5RCTNo serious risk of biasVery serious3No serious indirectnessVery serious2,4None127127—SMD 0.25 lower (1.29 lower to 0.8 higher)ÅOOO very lowCritical
VAS 48 hour after operation (better indicated by lower values)
3RCTNo serious risk of biasNo serious inconsistencyNo serious indirectnessSerious2None7474—SMD 0.35 lower (0.67 to 0.02 lower)ÅÅÅO moderateCritical
Postoperative 24-hour morphine consumption (better indicated by lower values)
6RCTNo serious risk of biasVery serious3No serious indirectnessSerious2None154146—SMD 1.27 lower (2.19 to 0.35 lower)ÅOOO very lowCritical
Postoperative 48-hour morphine consumption (better indicated by lower values)
3RCTNo serious risk of biasSerious5No serious indirectnessSerious2None9494—SMD 0.33 lower (0.8 lower to 0.15 higher)ÅÅOO lowCritical
Time to first opioid (better indicated by lower values)
8RCTSerious1Very serious3No serious indirectnessNo serious imprecisionNone215215—SMD 1.38 higher (0.41 to 2.34 higher)ÅOOO very lowCritical
Spinal anesthesia operation time (better indicated by lower values)
2RctNo serious risk of biasVery serious3No serious indirectnessVery serious2,4None4040—SMD 1.29 lower (2.54 to 0.03 lower)ÅOOO very lowCritical
First postoperative walking time (better indicated by lower values)
3RCTNo serious risk of biasNo serious inconsistencyNo serious indirectnessSerious2None120120—SMD 0.9 lower (1.17 to 0.63 lower)ÅÅÅO moderateCritical
1The included studies that had large biases in randomization, allocation concealment, and blinding. 2The sample size of the included study was too small. 3I2 ≥ 75%. 4The confidence interval is wide. 550% ≤ I2 ≤ 75%.