Battelfield acupuncture and femoral nerve block for treatment of postoperative pain in major orthopedic surgery

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.

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

Orthopedic Reviews ◽

10.4081/or.2017.7063 ◽

2017 ◽

Vol 9 (2) ◽

Cited By ~ 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.

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Comparison of Pain Control Outcomes between Direct, Continuous Adductor Canal Block and Ultrasonography Guided, Continuous Femoral Nerve Block after Total Knee Arthroplasty

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00098 ◽

2020 ◽

Vol 8 (5_suppl5) ◽

pp. 2325967120S0009

Author(s):

Seung-Min Na ◽

Ik-sun Choi ◽

Jong-Keun Seon ◽

Eun-Kyoo Song

Keyword(s):

Total Knee Arthroplasty ◽

Postoperative Pain ◽

Nerve Block ◽

Pain Control ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Walking Ability ◽

Postoperative Pain Control ◽

Adductor Canal ◽

Total Knee

Background: Purpose of this study was to compare the effects of direct, continuous adductor canal block (ACB) and ultrasonography guided, continuous femoral nerve block (FNB) on postoperative pain control, strength of the knee extensor, walking ability, and related complications after primary total knee arthroplasty. Methods: Between November 2018 and February 2019, 107 patients underwent primary total knee arthroplasty under spinal anesthesia. Forty eight patients received ACB and the other 59 received FNB for postoperative pain control. After the surgery, the patients received adductor canal or femoral nerve block via a catheter. 10 mL of 0.75% ropivacaine was administered initially, followed by continuous injection of 4 mL per hour. ACB was done before capsule repair by orthopedic surgeon and FNB was performed after the surgery. Data were prospectively collected out from these 107 patients. To evaluate postoperative pain control, the numerical rating scale scores at rest and during range of motion were recorded. To evaluate quadriceps strength, motor grade by manual muscle testing was measured. Walking ability was assessed by first weight bearing day and walking distance (steps). We also evaluated analgesic consumption using morphine equivalent and recorded related complications of peripheral nerve block. Results: No significant intergroup difference was observed in the numerical rating scale scores at rest and during range of motion on postoperative days 1, 2, 3, 4, and 5. ACB group had significantly greater quadriceps strength than did the FNB group, as evaluated by manual muscle testing on postoperative days 1. However, there was no significant difference onpostoperative days 2, 3, 4, and 5. These two groups showed no differences in walking ability in terms of first weight bearing day and walking distance. No significant intergroup difference was observed in analgesic consumption. Conclusions: The groups showed no difference in postoperative pain control. ACB showed better motor grade on postoperative day one compared with femoral nerve block, but which was similar in days after postoperative day one.

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