Korean J Anesthesiol.  2008 Nov;55(5):596-601. 10.4097/kjae.2008.55.5.596.

The effect of femoral nerve block combined with intravenous patient-controlled analgesia after a unilateral total knee replacement

• Chung MY
• Kim CJ

• KMID: 2243001
• DOI: http://doi.org/10.4097/kjae.2008.55.5.596

Abstract

BACKGROUND
Postoperative pain is a major concern after total knee replacement (TKR). Intravenous patient-controlled analgesia (IV PCA) is very easily controlled method for managing pain, however it is less effective than other methods, especially immediately after TKR. Therefore, we evaluated the effect of the femoral nerve block combined with IV PCA after a unilateral TKR for postoperative pain control.
METHODS
The patients in group I (n = 20) were given only IV PCA with morphine and group II (n = 20) taken femoral nerve block before extubation followed by IV PCA. We evaluated the effects of the femoral nerve block with 12 ml of 0.25% bupivacaine and epinephrine 1:400,000 on the postoperative cumulative opioid consumption, hourly dose during each time interval, numerical rating pain score, side effects and hemodynamics.
RESULTS
Cummulative opioid consumption was decreased in group II. The pain score in group II was lower than that in group I immediately after recovery of awareness and 3, 6 hours postoperatively. The hourly dose in group II was also lower than that in group I until 6 hours postoperatively. But there was no difference in side effects between the groups.
CONCLUSIONS
We concluded that femoral nerve block is effective as an easy adjuvant of IV PCA for pain management during early postoperative period after TKR.

Keyword

bupivacaine; femoral nerve block; intravenous patient controlled analgesia; total knee replacement

MeSH Terms

Analgesia, Patient-Controlled
Arthroplasty, Replacement, Knee
Bupivacaine
Epinephrine
Femoral Nerve
Humans
Morphine
Pain Management
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Postoperative Period
Bupivacaine
Epinephrine
Morphine