Anesth Pain Med.  2018 Oct;13(4):439-446. 10.17085/apm.2018.13.4.439.

Low concentration continuous femoral nerve block improves analgesia and functional outcomes after total knee arthroplasty in spinal anesthesia

• So HY
• Choi YS
• Kim SR

• KMID: 2436006
• DOI: http://doi.org/10.17085/apm.2018.13.4.439

Abstract

BACKGROUND
Total knee arthroplasty (TKA) is associated with severe pain postoperatively. Femoral nerve block is commonly used for pain control after TKA. This study investigated whether continuous femoral nerve block (CFNB) can improve postoperative analgesia and functional outcome as compared to intravenous patient controlled analgesia (PCA) in patients with TKA.
METHODS
We reviewed the electronic medical records of patients who underwent TKA with spinal anesthesia between March 2014 and February 2015. In Group IV, postoperative pain was managed by IV-PCA. Group CFNB received CFNB-PCA via a device. Thirty patients were enrolled per group. Patient outcomes were assessed by analgesia, functional outcomes, and health-related quality of life factors.
RESULTS
Additional analgesics and additional nerve block for adequate pain control were significantly more frequent in the IV than CFNB group (P = 0.015 and P = 0.012, respectively). Range of motion up to 105 degrees was prolonged in the IV group than CFNB group (P = 0.013). EuroQol five dimensions score was improved in the CFNB group than IV group postoperative 3 weeks (P = 0.003). The incidence of transfusion due to postoperative bleeding was significantly frequent in the IV group than CFNB group (P = 0.042).
CONCLUSIONS
Postoperative low concentration continuous femoral nerve block for analgesia after TKA improves analgesia, functional outcomes, and incidence of transfusion without falling risk.

Keyword

Blood transfusion; Femoral nerve; Knee replacement arthroplasty; Nerve block; Patient-controlled analgesia; Patient outcome assessments

MeSH Terms

Accidental Falls
Analgesia*
Analgesia, Patient-Controlled
Analgesics
Anesthesia, Spinal*
Arthroplasty, Replacement, Knee*
Blood Transfusion
Electronic Health Records
Femoral Nerve*
Hemorrhage
Humans
Incidence
Nerve Block
Pain, Postoperative
Patient Outcome Assessment
Quality of Life
Range of Motion, Articular
Analgesics

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