Abstract：
Guidelines are increasingly being used for clinical decision-making. Such guidelines are usually based on meta-analyses, which are generally derived from RCTs. However, their interpretations are often hindered as they do not always consider current clinical relevance. Analyses of RCTs assessing analgesic efficacy of advanced regional analgesic techniques in knee arthroplasty show that the majority of trials do not include a package of basic analgesics such as paracetamol, NSAIDs or cyclooxygenase-2 specific inhibitors, dexamethasone, and local infiltration analgesia in the comparator group. Consequently, the current approach to analyse meta-analyses of pain interventions is not optimal, and may lead to inadequate or inappropriate conclusions and clinical guidance.
摘要：
指南越来越多地用于临床决策。这样的指南通常基于荟萃分析，它们通常来自RCT。然而,他们的解释往往受到阻碍,因为他们并不总是考虑当前的临床相关性.对膝关节置换术中先进的局部镇痛技术镇痛效果的随机对照分析显示，大多数试验不包括一组基本镇痛药，如扑热息痛，NSAIDs或环氧合酶-2特异性抑制剂，地塞米松,对照组局部浸润镇痛。因此,目前分析疼痛干预措施荟萃分析的方法不是最佳的，并可能导致不充分或不恰当的结论和临床指导。
