{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:10:56Z","timestamp":1784121056602,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Oulu University Hospital"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pain management is one of the most important interventions in the emergency medical services. The femoral nerve block (FNB) is, among other things, indicated for pre\u2010 and post\u2010operative pain management for patients with femoral fractures but its role in the pre\u2010hospital setting has not been determined. The aim of this review was to assess the effect and safety of the FNB in comparison to other forms of analgesia (or no treatment) for managing acute lower extremity pain in adult patients in the pre\u2010hospital setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review (PROSPERO registration (CRD42018114399)) was conducted. The Cochrane and GRADE methods were used to assess outcomes. Two authors independently reviewed each study for eligibility, extracted the data and performed risk of bias assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four studies with a total of 252 patients were included. Two RCTs (114 patients) showed that FNB may reduce pain more effectively\u00a0than metamizole (mean difference 32\u00a0mm on a 100\u00a0mm VAS (95% CI 24 to 40)). One RCT (48 patients) compared the FNB with lidocaine and magnesium sulphate to FNB with lidocaine alone and was only included here for information regarding adverse effects. One case series included 90 patients. Few adverse events were reported in the included studies. The certainty of evidence was very low. We found no studies comparing FNB to inhaled analgesics, opioids or ketamine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evidence regarding the effectiveness and adverse effects of pre\u2010hospital FNB is limited. Studies comparing pre\u2010hospital FNB to inhaled analgesics, opioids or ketamine are lacking.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13600","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T07:04:37Z","timestamp":1586415877000},"page":"1038-1047","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Femoral nerve blocks for the treatment of acute pre\u2010hospital pain: A systematic review with meta\u2010analysis"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5537-9749","authenticated-orcid":false,"given":"Lasse","family":"Raatiniemi","sequence":"first","affiliation":[{"name":"Centre for Prehospital Emergency Care Oulu University Hospital Oulu Finland"},{"name":"Anaesthesia Research group MRC Oulu University Hospital and University of Oulu Oulu 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Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poul","family":"Kongstad","sequence":"additional","affiliation":[{"name":"Department of Prehospital Care and Disaster Medicine Region of Sk\u00e5ne Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jouni","family":"Kurola","sequence":"additional","affiliation":[{"name":"Centre for Prehospital Emergency Medicine Kuopio University Hospital and University of Eastern Finland Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine Faculty of Medicine and Health Sciences University of Link\u00f6ping Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-241X","authenticated-orcid":false,"given":"Marius","family":"Rehn","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences University of Stavanger Stavanger Norway"},{"name":"Department of Research Norwegian Air Ambulance Foundation Oslo Norway"},{"name":"Division of Prehospital Services Air Ambulance Department Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif","family":"Rogn\u00e5s","sequence":"additional","affiliation":[{"name":"Danish Air Ambulance Aarhus Denmark"},{"name":"Department of Anaesthesiology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e5rten","family":"Sandberg","sequence":"additional","affiliation":[{"name":"Division of Prehospital Services Air Ambulance Department Oslo University Hospital Oslo Norway"},{"name":"Faculty of Medicine University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunn 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