Analgesic Effect of Femoral Nerve Block on Postoperative Pain and Ambulation after Total Knee Arthroplasty

Objectives: Determine the analgesic effect of a single injection femoral nerve block on postoperative pain and ambulation, after total knee arthroplasty. Methods: In a prospective study, 84 patients undergoing total knee arthroplasty were randomly assigned to receive: either one single injection femoral nerve block and 100mg paracetamol combined with lornoxicam 4 mg administrated twice intravenously for 5 days (group 1, n=42) or only the aforementioned analgesics without nerve block for the same period (group 2, n=42). Distance walked on 5 first postoperative days and VAS pain score during first 5 days were reported. Patients with bilateral osteoarthritis, previous leg injury or serious cardiovascular disease were excluded. Statistical analysis was performed by statistical packet STATA 8.0 and significance was set at p-value <0.05. Results: Patients of group 1 walked longer distance than patients of group 2 on postoperative day 1, 2 and 3 (p<0.05).The VAS pain score decreased significantly from 7.8/10 to 4.1./10 in Group 1 (P<0.05) and from average 8.1/10 to 5.9/10 in Group 2 (p<0.05) at 5 days after surgery. Patients of group 1 experienced less pain than patients of group2 at 5 days after surgery according to VAS pain score (p<0.05). Conclusion: Single shot of femoral nerve block provides efficient pain relief on early postoperative period after total knee arthroplasty. This is associated with better ambulatory performance.

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Incidence of Suture-Method Catheter Dislocation with Femoral Nerve Block and Femoral Triangle Block after Total Knee Arthroplasty

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136687 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6687

Author(s):

Bulat Tuyakov ◽

Mateusz Kruszewski ◽

Lidia Glinka ◽

Oksana Klonowska ◽

Michal Borys ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Nerve Block ◽

Knee Arthroplasty ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Opioid Consumption ◽

Total Knee ◽

Group 2 ◽

Femoral Triangle ◽

Group 1

Catheter dislocation with continuous peripheral nerve blocks represents a major problem in clinical settings. There is a range of factors affecting the incidence of catheter dislocation, including catheter type. This study aimed to assess the incidence of suture-method catheter (SMC) dislocation 24 h after total knee arthroplasty (TKA), with continuous femoral nerve block (CFNB) and continuous femoral triangle block (CFTB), respectively. In the prospective randomized trial, 40 patients qualified for TKA with SMC and were divided into two groups, those who received CFNB (Group 1, n = 20) and those who received CFTB (Group 2, n = 20). After 24 h, the degree of catheter displacement (cm), pain intensity (NRS) and opioid consumption (mg) was assessed. The catheter dislocation rates were found to be 15% in Group 1 versus 5% in Group 2, with the catheter dislocated by 0.83 cm (SD = ±0.87) and 0.43 cm (SD = ±0.67), respectively. There were no differences in NRS score (p = 0.86) or opioid consumption (p = 0.16) between the groups. In each case, a displaced catheter was successfully repositioned by pulling, which clinically resulted in a lower NRS score. The results of the study suggest that CFTB with SMC may be used after TKA with a good effect, as it is associated with low catheter dislocation rates and an adequate analgesic effect.

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