Continuous Femoral Nerve Blockade versus Continuous Epidural Analgesia for Postoperative Pain Relief in Knee Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hala Gomaa Salama ◽  
Ahmed Ali El- Shebiny ◽  
Abd Al Aziz Abdullah Abd Al Aziz ◽  
Mariam Mahmoud Ahmed Ali Shehata
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Weight Bearing ◽  
Femoral Nerve ◽  
Disease Process ◽  
Continuous Epidural Analgesia ◽  
Significant Difference ◽  
Continuous Femoral Nerve Block

Abstract Background The progression of osteoarthritis is characteristically slow, occurring over several years or decades. Over this period, the patient can become less and less active and thus more susceptible to morbidities related to decreasing physical activity (including potential weight gain). Early in the disease process, the joints may appear normal. However, the patient’s gait may be antalgic if weight-bearing joints are involved. Objective Compare the benefits of continuous femoral nerve block (CFNB) with those of continuous epidural analgesia CEPA for postoperative pain management after Knee surgeries. Methods This study is a randomized controlled clinical trial was conducted in Ain Shams University Hospitals after obtaining approval from the Research Ethical Committee of Ain Shams University during a period of three months. Patients undergoing primary unilateral TKA for osteoarthritis, were recruited at least one day prior to the scheduled surgery, male and female patients. Results There was significant difference in terms of pain scoring between continuous femoral nerve block (CFNB) and continuous epidural analgesia (CEA) in the first 6 hours, 12 hours, 24 hours, 48 hours, 72 hours but non significant difference in incidence of side effects Conclusion Our study showed that CEA had optimal analgesia and pain control than CFNB in management of post operative pain after total knee replacement.

scholarly journals Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Shoji Nishio ◽  
Shigeo Fukunishi ◽  
Tomokazu Fukui ◽  
Yuki Fujihara ◽  
Shohei Okahisa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Total Hip Arthroplasty ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Sciatic Nerve Block ◽  
Nerve Blockade ◽  
Continuous Femoral Nerve Block

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

Evaluation of Femoral Nerve Blockade for Postoperative Analgesia in Dogs Undergoing Stifle Arthrotomy

1997 ◽  
Vol 10 (01) ◽  
pp. 37-44 ◽  
Author(s):  
D. Riedesel ◽  
K. R. Cox
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Rating Scale ◽  
Femoral Nerve Block ◽  
Numerical Rating Scale ◽  
Femoral Nerve ◽  
Systolic Pressure ◽  
Saline Group ◽  
Perineural Injection ◽  
Significant Difference

SummaryThe efficacy of the femoral nerve block (FNB) in alleviating postoperative pain was evaluated in dogs undergoing stifle arthrotomy. The pre- and postoperative nerve blocks were compared to intraarticular administration of a local anaesthetic. Forty-eight dogs with a ruptured cranial cruciate ligament were randomly assigned to the following groups: Group A (n = 16) received a femoral perineural injection prior to surgery; eight dogs within this group were given 0.5% bupivacaine and eight dogs received 0.9% saline. Group B (n = 16) had a femoral perineural injection immediately after surgery; eight dogs received 0.5% bupivacaine and eight received 0.9% saline. Group C (n = 16) dogs were given 0.5% bupivacaine (n = 8) or 0.9% saline (n = 8) intraarticularly. Postoperative pain was evaluated using a visual analog scale and a numerical rating scale, including measurement of heart rate, respiratory rate and systolic pressure. The dogs were scored preoperatively and at zero to six and at 24 hours after the operation. A significant difference was not noted between groups during the time until the first dose of supplemental analgesia nor in the total dose of supplemental analgesia required. The duration of the operation was found to be negatively correlated with the duration of postoperative analgesic effect. There was not any significant difference between the groups in pain scores at any time.Femoral nerve block (FNB) was evaluated for the control of postoperative pain in dogs undergoing stifle arthrotomy. FNB, using bupivacaine, was performed preoperatively and was compared to a postoperative FNB, and to saline controls. In addition, the efficacy of the FNB was compared to intra-articularly administered bupivacaine. Differences were not found between any groups in the alleviation of postoperative pain.

scholarly journals Dose-dependent neurotoxicity caused by the addition of perineural dexmedetomidine to ropivacaine for continuous femoral nerve block in rabbits

2019 ◽  
Vol 47 (6) ◽  
pp. 2562-2570 ◽  
Author(s):  
Hai-Li Wang ◽  
Guang-Ying Zhang ◽  
Wei-Xin Dai ◽  
Li-Pei Shu ◽  
Qiu-Feng Wei ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Nerve Block ◽  
Myelin Sheath ◽  
Femoral Nerve Block ◽  
Light And Electron Microscopy ◽  
Femoral Nerve ◽  
Significant Difference ◽  
Continuous Femoral Nerve Block ◽  
Group A ◽  
Neurotoxic Lesions

Objective This study was designed to evaluate the neurotoxicity of dexmedetomidine combined with ropivacaine for continuous femoral nerve block in rabbits. Methods Thirty New Zealand rabbits were randomly divided into 5 groups of 6 rabbits each and received a continuous femoral nerve block with saline; 0.25% ropivacaine; or 1, 2, or 3 µg/mL of dexmedetomidine added to 0.25% ropivacaine (Groups A–E, respectively). Sensory and motor function was assessed after the nerve block. The rabbits were anesthetized and killed after 48 hours of a continuous femoral nerve block, and the femoral nerves were removed for light and electron microscopy analyses. Results The behavior scores were highest in Group A at 2 and 6 hours after injection. The scores were higher in Groups B and C than in Groups D and E at these same time points. All groups showed normal pathological tissues in the femoral nerves under optical microscopy. Under electron microscopy, histological abnormalities were observed only in Group E; none of the other groups exhibited pathological abnormalities. Quantitative analysis of the myelin sheath area revealed no significant difference in the axonal area, total area of the myelin sheath, or ratio of the total axonal area to the total area of the myelin sheath in all groups. Conclusion The lowest doses of dexmedetomidine (1 and 2 µg/mL) combined with 0.25% ropivacaine for continuous femoral nerve block resulted in no neurotoxic lesions, but the higher dose (3 µg/mL) resulted in neurotoxic lesions in this rabbit experimental model.

scholarly journals Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Lihua Peng ◽  
Li Ren ◽  
Peipei Qin ◽  
Jing Chen ◽  
Ping Feng ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Controlled Trial ◽  
Femoral Nerve ◽  
Patient Controlled Analgesia ◽  
Chronic Postoperative Pain ◽  
Intravenous Analgesia ◽  
Continuous Femoral Nerve Block ◽  
Total Knee

Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) and their impact on knee function and chronic postoperative pain.Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB) or intravenous patient controlled analgesia (group PCIA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded.Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P<0.05). Analgesic rescue medications were significantly reduced in patients receiving CFNB (P<0.001andP=0.031, resp.).Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.

scholarly journals Comparison of Continuous Epidural Blockade and Continuous Femoral Nerve Block on Postoperative Pain in Total Knee Replacement Surgeries: A Prospective Randomised Controlled Study

2020 ◽  
Vol 5 (1) ◽  
pp. 67-73
Author(s):  
K. Shanthini ◽  
Nishkala Chandra Sekar ◽  
Kusuma Mathai
Keyword(s):  
Postoperative Pain ◽  
Total Knee Replacement ◽  
Nerve Block ◽  
Knee Replacement ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Epidural Block ◽  
Continuous Femoral Nerve Block ◽  
Total Knee

Background: The use of epidural analgesia in the management of postoperative pain following orthopedic surgeries has evolved as a critical component of a multimodal approach to achieve the goal of pain relief, early mobilization, and improved compliance with physiotherapy resulting in overall improved outcomes. Aim: The aim of this study is to compare continuous femoral nerve block with continuous epidural block technique for postoperative analgesia in patients undergoing elective total knee replacement surgery.Subjects and Methods:The patients belonging to the ASA I to III scheduled for various knee surgeries under spinal anesthesia were enrolled in this study. They were randomly divided into two equal groups of thirty-three patients each. The Group F patients received continuous femoral nerve blockade and in the Group E patients continuous epidural blocked preoperatively.Results:The analgesic efficacy of both continuous femoral nerve block and continuous epidural nerve block was equal as measured by the visual analogue scores. The incidence of Hypotension was more in the Epidural group. The adverse effects due to the Continuous Femoral Nerve block were lower in comparison with the Continuous Epidural block technique.Conclusion:Continuous femoral nerve blockade provides postoperative analgesia equivalent to that obtained with a continuous epidural blocked but with lesser side effects.

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