Regional blocks in multimodal analgesia and early rehabilitation after arthroplasty: an integrative review
DOI:
https://doi.org/10.62827/fb.v27i8.1288Keywords:
Postoperative Pain; Early Ambulation; Recovery of Function; Length of Stay; Nerve Block.Abstract
Introduction: Pain control after arthroplasty should enable mobilization without imposing motor deficits that delay physiotherapy. Objective: To critically synthesize the effects of regional blocks within multimodal analgesia on pain, opioid use, and early recovery after primary knee or hip arthroplasty. Methods: A qualitative integrative review was conducted. Initial searches of PubMed/MEDLINE and the Physiotherapy Evidence Database were performed in July and August 2026; in September 2026, a sensitive supplementary PubMed/MEDLINE search was conducted, the PEDro searches were reproduced, and LILACS was added. Comparative adult studies were eligible when reporting an analgesic outcome together with early function or length of stay. One author performed selection, extraction, and criterion-level appraisal using the Mixed Methods Appraisal Tool, without independent verification. Results: The searches identified 1,137 records; 70 full texts were assessed and 60 studies were included, 30 on knee and 30 on hip arthroplasty. Fifty-seven were randomized, three were prospective nonrandomized studies, and 31 of 101 reports sought were not retrieved. Distal sensory blocks and motor-sparing strategies reduced pain or preserved strength in some trials, but effects on ambulation and discharge were inconsistent. Conclusion: Functional benefits were heterogeneous and conditional on the comparator, cointerventions, and rehabilitation pathway; the evidence does not establish the overall superiority of any technique.
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