Effectiveness of continuous versus single injection femoral nerve block for total knee arthroplasty: A double blinded, randomized trial

被引:44
作者
Dixit, Varun [1 ,5 ]
Fathima, Samreen [2 ]
Walsh, Stephen M. [3 ,4 ]
Seviciu, Alexandria [1 ]
Schwendt, Ivan [1 ]
Spittler, Karl-Heinz [1 ]
Briggs, Dana [1 ]
机构
[1] Eastern Maine Med Ctr, Dept Anesthesia, 489 State St, Bangor, ME 04401 USA
[2] Eastern Maine Med Ctr, Clin Res Ctr, One Cumberland Pl, Bangor, ME 04401 USA
[3] Eastern Maine Med Ctr, Dept Orthoped, Bangor, ME 04401 USA
[4] Down East Orthoped, Bangor, ME 04401 USA
[5] 5017 Westcott Ridge Dr, Glen Allen, VA 23059 USA
关键词
Femoral nerve block; Single injection femoral nerve block; Continuous catheter femoral nerve block; Randomized control trial; Total knee arthroplasty; ADDUCTOR CANAL BLOCK;
D O I
10.1016/j.knee.2018.04.001
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background: Effective analgesia following total knee arthroplasty (TKA) is impoitant for maximizing patient satisfaction, early participation in physical therapy and redudng the hospital stay. This trial compared continuous catheter femoral nerve block (cFNB) to single injection femoral nerve block (sFNB) in terms of analgesia, opioid consumptio n; and participation in physical therapy and associated side effects. Methods: This randomized, double blinded trial was conducted in a min-university hospital setting, without major changes to anesthesia or surgical clinical pathways. A total of 85 patients scheduled for primary TKA were randomized to receive either cFNB (n = 44) or sFNB (n = 41). All patients had ENS with 0.5% ropivacaine bolus followed by subarachnoid block for surgery. Postoperatively, 0.2% ropivacaine infusion was commenced in cFNB group and a sham catheter was taped to the skin in sFNB group. All patients received a structured multimodal analgesia regimen throughout hospital stay. The primary outcomes were peak resting visual analogue scale (VAS) scores and morphine consumption at 48 h postoperatively. Results: VAS scores (Mean difference 025, 95% Confidence Interval (CI) 0.56 to 1.06; [P = 0.1961) and morphine consumption (Mean difference 0.95 mg, 95% CI -9.99 to 11.89; [P = 0.863]) were not significantly different among patients who received cFNB versus sFNB at 48 h. There was no difference in hospital stay (P = 0.517) or long-term functional recovery between the two groups (P = 0.385). Conclusions: sFNB block provides equal pain relief compared with cFNB, after TKA with no significant difference in opioid consumption, hospital stay, physical therapy outcomes or associated side effects. (C) 2018 Elsevier B.V. All rights reserved.
引用
收藏
页码:623 / 630
页数:8
相关论文
共 14 条
[1]
Femoral nerve blocks for acute postoperative pain after knee replacement surgery [J].
Chan, Ee-Yuee ;
Fransen, Marlene ;
Parker, David A. ;
Assam, Pryseley N. ;
Chua, Nelson .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (05)
[2]
Hospital Length of Stay following Primary Total Knee Arthroplasty: Data from the Nationwide Inpatient Sample Database [J].
El Bitar, Youssef F. ;
Illingworth, Kenneth D. ;
Scaife, Steven L. ;
Horberg, John V. ;
Saleh, Khaled J. .
JOURNAL OF ARTHROPLASTY, 2015, 30 (10) :1710-1715
[3]
Utilization of Femoral Nerve Blocks for Total Knee Arthroplasty [J].
Gabriel, Rodney A. ;
Kaye, Alan D. ;
Nagrebetsky, Alexander ;
Jones, Mark R. ;
Dutton, Richard P. ;
Urman, Richard D. .
JOURNAL OF ARTHROPLASTY, 2016, 31 (08) :1680-1685
[4]
Adductor Canal Block Versus Femoral Canal Block for Total Knee Arthroplasty: A Meta-Analysis What Does the Evidence Suggest? [J].
Hussain, Nasir ;
Ferreri, Thomas Gerald ;
Prusick, Parker Joseph ;
Banfield, Laura ;
Long, Bradley ;
Prusick, Vincent Roger ;
Bhandari, Mohit .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2016, 41 (03) :314-320
[5]
Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Total Knee Arthroplasty A Randomized, Double-blind Study [J].
Jaeger, Pia ;
Zaric, Dusanka ;
Fomsgaard, Jonna S. ;
Hilsted, Karen Lisa ;
Bjerregaard, Jens ;
Gyrn, Jens ;
Mathiesen, Ole ;
Larsen, Tommy K. ;
Dahl, Jorgen B. .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2013, 38 (06) :526-532
[6]
Adductor Canal Block versus Femoral Nerve Block for Total Knee Arthroplasty [J].
Kim, David H. ;
Lin, Yi ;
Goytizolo, Enrique A. ;
Kahn, Richard L. ;
Maalouf, Daniel B. ;
Manohar, Asha ;
Patt, Minda L. ;
Goon, Amanda K. ;
Lee, Yuo-yu ;
Ma, Yan ;
YaDeau, Jacques T. .
ANESTHESIOLOGY, 2014, 120 (03) :540-550
[7]
King K., CONTINUOUS FEMORAL N
[8]
Adductor Canal Block for Total Knee Arthroplasty The Perfect Recipe or Just One Ingredient? [J].
Mariano, Edward R. ;
Perlas, Anahi .
ANESTHESIOLOGY, 2014, 120 (03) :530-532
[9]
Use of invasive placebos in research on local anaesthetic interventions [J].
McGuirk, S. ;
Fahy, C. ;
Costi, D. ;
Cyna, A. M. .
ANAESTHESIA, 2011, 66 (02) :84-91
[10]
Inpatient Falls after Total Knee Arthroplasty [J].
Memtsoudis, Stavros G. ;
Danninger, Thomas ;
Rasul, Rehana ;
Poeran, Jashvant ;
Gerner, Philipp ;
Stundner, Ottokar ;
Mariano, Edward R. ;
Mazumdar, Madhu .
ANESTHESIOLOGY, 2014, 120 (03) :551-563