• There was considerable heterogeneity in the way analgesic interventions were performed, we grouped them into five broad categories of interventions, which had been investigated in a sufficient number of studies to allow for the creation of pain trajectories:(1) LIA (1209 patients); (2) single shot nerve block (S-block, 515 patients);(3) continuous nerve block (C-block, 1430 patients);(4) multimodal drug therapy (1198 patients); and (5) a primarily opioid-focused analgesic regimen representing the control group (C, 1621 patients).
• 作者将其分为五大类干预措施，这些干预措施已经在足够数量的研究中进行了调查，以允许创建疼痛轨迹:(1) 局部浸润阻滞（LIA） (1209名患者)；(2)单发神经阻滞(S型阻滞，515例)；(3)持续神经阻滞(C-阻滞，1430例)；(4)多模式药物治疗(1198例)；和(5)对照组(C，1621名患者)：主要以阿片样物质为焦点的镇痛方案。
• (1)LIA: The optimal technique and location of LIA is a subject of debate, with surgical practice varying widely, reflected also in the broad spectrum of different approaches among the 23 analysed studies. The LIA interventions differed in respect to the infiltration site, the type of the local anaesthetic and other adjuvant drugs, the timing of infiltration, and the accompanying systemic analgesic regimen. (LIA干预在浸润部位、局部麻醉剂和其他辅助药物的类型、浸润时间和伴随的全身镇痛方案方面有所不同)
• (2) Peripheral nerve blocks(including single shot nerve block and continuous nerve block ):there was heterogeneity of regional anaes-thetic technique, including the type of block, the timing, the local anaesthetic used, and the means of needle guidance (ultrasound[US], landmarks, or nerve stimulation). Different peripheral nerve blocks re currently used for perioperative management in hipsurgery. Seven types were included in this study: psoas compartment block, fascia iliaca block, femoral nerve sheath block, lumbar plexus block, subcostal nerve block, lateral femoral cutaneous nerve (LFCN) block, and the three-in-one block.(区域麻醉技术也存在异质性，包括阻滞类型、时机、所用局部麻醉剂和针引导方式(超声、界标或神经刺激)。不同的周围神经阻滞目前用于髋关节手术的围手术期处理。本研究包括七种类型:腰大肌筋膜室阻滞、髂筋膜阻滞、股神经鞘阻滞、腰丛阻滞、肋下神经阻滞、股外侧皮神经(LFCN)阻滞和三合一阻滞)
• (3)multimodal drug therapy: The multimodal drug therapy group was defined by absence of use of LIA or peripheral nerve blocks. The drug regimens and the dosages varied between studies but consisted mainly of NSAIDs, ketamine, gabapentin, COX-2 in-hibitors, pregabalin, glucocorticoids, and clonidine. (多模式药物治疗组的定义是不使用LIA或周围神经阻滞。药物方案和剂量因研究而异，但主要由非甾体抗炎药、氯胺酮、加巴喷丁、环氧化酶-2抑制剂、普瑞巴林、糖皮质激素和可乐定组成)
ü The first outcome: the patient’s postoperative pain scores immediately after THA and up to 120 h postoperatively, both at rest and during activity, when available.
ü Secondary outcome: hourly and cumulative opioid consumption measured in milligrams of intravenous morphine equivalents according to the equianalgesic chart provided by the Pain Assessment and Management Initiative.
Mean pain scores and standard deviation of pain scores were extracted from each study.(从每项研究中提取平均疼痛评分和疼痛评分的标准偏差)
(1) For studies that reported median pain scores with inter-quartile ranges or ranges, an approximate mean value and standard deviation were calculated. More specifically, suppose the reported median and inter-quartile ranges were m and q1to q3, the approximate mean value would be mean =(q1+m+q3)/3, and the standard deviation would be S=(q3-q1)/(2φ‾1)x(0.75n—0.125)/(n+0.25)。
(2) For studies that reported median and mini-mum to maximum ranges (a to b, where a is the minimum and b is the maximum), the approximate mean would be mean=(a+2m+b)/4, and the standard deviation would be S=(b-a)/(2φ‾1)x(n—0.375)/(n+0.25).
(3) In addition, for studies that reported mean values and the range between minimum and maximum values, the approximate standard deviation would be S=(b-a)/4.