Objectives: To compare the analgesic and functional outcomes of continuous neuroablative radiofrequency (CNARF) and pulsed neuromodulative radiofrequency (PNMRF) treatment of genicular nerves up to 1 year after the intervention and to identify predictors associated with a successful outcome (defined as an at least 50% reduction in the pre-interventional visual analog scale [VAS] rating) after genicular radiofrequency treatment. Design: A prospective randomized controlled trial. Setting: The Pain Department of the Jerez de la Frontera University Hospital, Cadíz, Spain, from January 2018 until May 2019. Subjects: Patients with grade 3–4 gonarthritis suffering from knee pain, with a VAS score ≥5 for >6 months. Methods: Eligible participants were randomly assigned to receive either CNARF or PNMRF of the superior medial, superior lateral, and inferior medial genicular nerves. The VAS and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores were assessed before and at 1, 6, and 12 months after treatment. Medication use was quantified before and at 6 months after the intervention. Potential characteristics associated with the efficacy of radiofrequency intervention were explored by using multivariable statistical models. Results: A total of 188 participants were included. The magnitude and duration of beneficial effect and reduction in analgesic use were significantly greater in the CNARF group. Success at 6 months after radiofrequency treatment decreased with grade 4 gonarthritis; higher pre-interventional VAS score; and concomitant depression, anxiety disorder, and diabetes mellitus. Conclusions: Therapeutic efficacy and reduction in analgesic consumption were superior after CNARF. Treatment success at 6 months after radiofrequency intervention decreased with more severe gonarthritis; higher pre-interventional pain intensity; and concomitant depression, anxiety disorder, and diabetes mellitus.

This meta-analysis is the first to compare tracheal intubation conditions and haemodynamic responses produced by various types and doses of neuromuscular blocking agents (NMBAs) in paediatric anaesthesia while also exploring factors associated with variability in outcomes. Randomised controlled and controlled clinical trials involving healthy paediatric participants (0-12 yr) were included. Trials compared intubation conditions using various NMBA interventions or NMBA-free settings under direct laryngoscopy. Outcomes included odds ratios (ORs) for excellent and acceptable intubation conditions, and mean differences for MAP and HR. Bayesian network, pairwise, and cumulative meta-analyses, along with meta-regression, assessed NMBA effectiveness and covariate effects. Data from 105 trials (8008 participants) were analysed. Suxamethonium ≥1.50 mg kg^-1 and rocuronium ≥0.90 mg kg^-1 provided similar intubation conditions, though not consistently within 60 s. Other NMBAs were, on average, slower and less effective. Opioids decreased MAP and HR but did not improve intubation conditions when combined with suxamethonium ≥1.00 mg kg^-1 or rocuronium ≥0.90 mg kg^-1. Non depolarising NMBAs enhanced excellent (OR: 2.97 [1.82-5.10]) and acceptable intubation conditions (OR: 2.29 [1.14-4.39]) more in younger children (1.64 [1.08-2.20] yr) than in older ones (5.53 [4.04-7.01] yr). Intubation without NMBAs was most difficult in neonates and infants, with conditions improving until about age 4 yr. Beyond this, the difference in intubation quality between groups with and without NMBAs increased with age, indicating a greater benefit of using NMBAs in older children. Values are mean (95% credible interval). We present a meta-analytical approach to synthesise and consolidate evidence from previous research and demonstrate how neuromuscular blocking agent type and dose, intubation timing, age, and induction drugs affect the safety and efficacy of paediatric airway management. Low-to-moderate confidence can be assigned to the recommendations from this meta-analysis. PROSPERO (CRD42018097146).