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Despite advances in our understanding of knee innervation, consensus regarding the most effective regional anaesthesia techniques for this surgical population is lacking. This network meta\u2010analysis compared effectiveness of regional anaesthesia techniques used to provide analgesia for anterior cruciate ligament reconstruction. Randomised trials examining regional anaesthesia techniques for analgesia following anterior cruciate ligament reconstruction were sought. The primary outcome was opioid consumption during the first 24\u2009h postoperatively. Secondary outcomes were: rest pain at 0, 6, 12 and 24\u2009h; area under the curve of pain over 24\u2009h; and opioid\u2010related adverse effects and functional recovery. Network meta\u2010analysis was conducted using a frequentist approach. A total of 57 trials (4069 patients) investigating femoral nerve block, sciatic nerve block, adductor canal block, local anaesthetic infiltration, graft\u2010donor site infiltration and systemic analgesia alone (control) were included. For opioid consumption, all regional anaesthesia techniques were superior to systemic analgesia alone, but differences between regional techniques were not significant. Single\u2010injection femoral nerve block combined with sciatic nerve block had the highest p value probability for reducing postoperative opioid consumption and area under the curve for pain severity over 24\u2009h (78% and 90%, respectively). Continuous femoral nerve block had the highest probability (87%) of reducing opioid\u2010related adverse effects, while local infiltration analgesia had the highest probability (88%) of optimising functional recovery. In contrast, systemic analgesia, local infiltration analgesia and adductor canal block were each poor performers across all analgesic outcomes. Regional anaesthesia techniques that target both the femoral and sciatic nerve distributions, namely a combination of single\u2010injection nerve blocks, provide the most consistent analgesic benefits for anterior cruciate ligament reconstruction compared with all other techniques but will most likely impair postoperative function. Importantly, adductor canal block, local infiltration analgesia and systemic analgesia alone each perform poorly for acute pain management following anterior cruciate ligament reconstruction.<\/jats:p>","DOI":"10.1111\/anae.15873","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T06:17:31Z","timestamp":1667456251000},"page":"207-224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Network meta\u2010analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction"],"prefix":"10.1111","volume":"78","author":[{"given":"N.","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Ohio State University, Wexner Medical Center  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Brull","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Women's College Hospital, University of Toronto  ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Vannabouathong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Ohio State University, Wexner Medical Center  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Speer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Ohio State University, Wexner Medical Center  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Lagnese","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Cleveland Clinic Akron General  Akron OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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