Analgesic efficacy of associating a sciatic block to a femoral block in the posotperative period of total knee arthroplasty

2011 ◽  
Vol 28 ◽  
pp. 119-120 ◽  
Author(s):  
A. Serrano ◽  
X. Santiveri ◽  
E. Bisbe ◽  
P. Ortiz ◽  
L. Puig ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Analgesic Efficacy ◽  
Total Knee

Analgesic efficacy of adding the IPACK block to a multimodal analgesia protocol for primary total knee arthroplasty

2020 ◽  
Vol 45 (10) ◽  
pp. 799-804
Author(s):  
Jason Ochroch ◽  
Victor Qi ◽  
Ignacio Badiola ◽  
Taras Grosh ◽  
Lu Cai ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Analgesic Efficacy ◽  
Multimodal Analgesia ◽  
Posterior Capsule ◽  
Quality Of Recovery ◽  
Functional Measures ◽  
Total Knee

Background and objectivesPeripheral nerve blocks have been integrated into most multimodal analgesia protocols for total knee arthroplasty (TKA). The adductor canal block (ACB) has gained popularity because of its quadriceps muscle sparing. Similarly, local anesthetic injection between the popliteal artery and the posterior capsule of the knee, IPACK block, has been described to provide analgesia to the posterior capsule of the knee with motor-sparing qualities. This prospective randomized controlled trial aimed to assess the analgesic efficacy of adding the IPACK block to our current multimodal analgesic regimen, including the ACB, in patients undergoing primary TKA.Methods119 patients were randomized to receive either an IPACK or a sham block in addition to multimodal analgesia and an ACB. We were set to assess pain in the back of the knee 6 hours after surgery. Other end points included quality of recovery after surgery, pain scores, opioid requirements, and functional measures.ResultsPatients who received the IPACK block had less pain in the back of the knee 6 hours after surgery when compared with the sham block: 21.7% vs 45.8%, p<0.01. There was marginal improvement in other pain measures in the first 24 hours after surgery. However, opioid requirements, quality of recovery and functional measures were similar between the two groups.ConclusionThe IPACK block reduced the incidence of posterior knee pain 6 hours postoperatively.

scholarly journals Analgesic Efficacy of Single-Shot Adductor Canal Block Before Versus After Primary Total Knee Arthroplasty: A Randomized Controlled Trial.

2021 ◽  
Author(s):  
Snir Heller ◽  
Shai Shemesh ◽  
Oleg Rukinglaz ◽  
Nir Cohen ◽  
Steven Velkes ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Primary Total Knee Arthroplasty ◽  
Analgesic Efficacy ◽  
Randomized Controlled ◽  
Vas Scores ◽  
Total Knee ◽  
Primary Total Knee

Abstract Background: Total knee arthroplasty (TKA) is associated with severe postoperative pain. Multimodal analgesia, including peripheral nerve block, is recommended for post-operative pain relief. Administration of some pain medications prior to surgery has shown to be more effective than after the operation. This is a prospective, randomized controlled trial designed to compare the analgesic efficacy of the adductor canal block (ACB) performed immediately before or immediately after primary total knee arthroplasty (TKA). We hypothesized that ACB before the surgery will reduce postoperative pain and improve knee function.Methods: A total of 50 patients were enrolled and randomized into 2 groups, with 26 patients receiving a preoperative ACB and 24 receiving a postoperative ACB. Results: Treatment groups were similar in terms of gender (p=0.83), age (p=0.61) weight (p=0.39) and ASA score. Average visual analogue scale (VAS) on arrival to the post-anesthesia care unit (PACU) were 4.9±3.2 in the preoperative ACB versus 3.4±2.8 for the postoperative ACB (p=0.075). VAS scores at different time points as well as the mean, minimal and maximal reported VAS scores were not significantly different between the two groups. The cumulative quantities of Fentanyl administered by the anesthesia team was comparable between the groups. Similarly, the dosage of Morphine, Tramadol, Acetaminophen and Dipyrone showed only small variations. The Quality of Recovery Score, Knee Society Scores and knee range of motion did not differ between the groups. Conclusions: Our findings demonstrate no significant differences in patient total narcotics consumption, pain scores and functional scores, between preoperative and postoperative ACB in patients undergoing TKA. Trial Registration: The trial was registered at www.clinicaltrials.gov and was assigned the registration number NCT02908711Level of Evidence: level I randomized controlled trial

scholarly journals Analgesic Efficacy of the Intra-articular Administration of S(+)- Ketamine in Patients Undergoing Total Knee Arthroplasty

2012 ◽  
Vol 62 (5) ◽  
pp. 665-675 ◽  
Author(s):  
Hireno Guará Sobrinho ◽  
João Batista Santos Garcia ◽  
Jose Wanderley Vasconcelos ◽  
José Carlos Amaral Sousa ◽  
Letácio Santos Garcia Ferro
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Analgesic Efficacy ◽  
Total Knee

scholarly journals The analgesic efficacy and safety of peri-articular injection versus intra-articular injection in one-stage bilateral total knee arthroplasty: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kai-Yuan Cheng ◽  
Bin Feng ◽  
Hui-Ming Peng ◽  
Yan-Yan Bian ◽  
Lin-Jie Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Pain Score ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Operation Time ◽  
Analgesic Efficacy ◽  
Local Infiltration Analgesia ◽  
Total Knee ◽  
Straight Leg Raise

Abstract Background As an essential component of multimodal analgesia approaches after total knee arthroplasty (TKA), local infiltration analgesia (LIA) can be classified into peri-articular injection (PAI) and intra-articular injection (IAI) according to administration techniques. Currently, there is no definite answer to the optimal choice between the two techniques. Our study aims to investigate analgesic efficacy and safety of PAI versus IAI in patients receiving simultaneous bilateral TKA. Methods This randomized controlled trial was conducted from February 2017 and finished in July 2018. Sixty patients eligible for simultaneous bilateral total knee arthroplasty were randomly assigned to receive PAI on one side and IAI on another. Primary outcomes included numerical rating scale (NRS) pain score at rest or during activity at 3 h, 6 h, 12 h, 24 h, 48 h, and 72 h following surgery. Secondary outcomes contained active or passive range of motion (ROM) at 1, 2, and 3 days after surgery, time to perform straight leg raise, wound drainage, operation time, and wound complications. Results Patients experienced lower NRS pain scores of the knee receiving PAI compared with that with PAI during the first 48 h after surgery. The largest difference of NRS pain score at rest occurred at 48 h (PAI: 0.68, 95%CI[0.37, 0.98]; IAI: 2.63, 95%CI [2.16, 3.09]; P < 0.001); and the largest difference of NRS pain score during activity also took place at 48 h (PAI: 2.46, 95%CI [2.07, 2.85]; IAI: 3.90, 95%CI [3.27, 4.52]; P = 0.001). PAI group had better results of range of motion and time to perform straight leg raise when compared with IAI group. There were no differences in operation time, wound drainage, and wound complication. Conclusion PAI had the superior performance of pain relief and improvement of range of motion to IAI. Therefore, the administration technique of peri-articular injection is recommended when performing local infiltration analgesia after total knee arthroplasty. Trial registration The trial was retrospectively registered in the Chinese Clinical Trial Registry as ChiCTR1800020420 on 29th December, 2018. Level of evidence Therapeutic Level I.

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