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Table 4 GRADE, summary of findings, IPACK versus non-IPACK for patients with primary TKA

From: Analgesic efficacy of adding the IPACK block to multimodal analgesia protocol for primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Patient or Population: Patients with primary total knee arthroplasty

Setting: postoperative care in hospital, Egypt (1 trial), India (2 trials), America (3 trials), Thailand (3 trials), China (4 trials)

Intervention: The interspace between the popliteal artery and capsule of the knee, IPACK

Comparison: Non-IPACK

Outcome indicator

Importance

Relative effect (95%CI)

No. of Participants (studies)

Quality of the evidence

Comments

Pain at rest (6–12 h)

Critical

− 0.960 (− 1.467, − 0.454)

1309 (13)

⊕⊕⊕○ Moderate a

inconsistency

Pain at ambulation (6–12 h)

Important

− 0.691 (− 1.064, − 0.318)

1223 (13)

⊕⊕⊕○ Moderate b

inconsistency

Morphine consumption (24–48 h)

Critical

− 2.979 (− 5.714, − 0.244)

812 (10)

⊕⊕⊕⊕ High

inconsistency

Morphine requirement (12–24 h)

Important

0.506 (0.309, 0.829)

281 (4)

⊕⊕⊕○ Moderate

inconsistency

Ambulation distances (POD2)

Important

1.743 (0.339, 3.147)

439 (5)

⊕⊕⊕○ Moderate

inconsistency

Sleep disturbance (POD1)

Important

0.388 (0.185, 0.812)

264 (4)

⊕⊕⊕○ Moderate

Small number of participants

  1. GRADE Working Group grades of evidence. High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate
  2. aDowngraded by two levels due to inconsistency (unexplained high heterogeneity without change results, I2 > 75%)
  3. bDowngraded by one level due to inconsistency (unexplained high heterogeneity without change results, I2 > 50%)