scholarly journals Comparison of patient and surgeon satisfaction in patients undergoing knee arthroscopy with peripheral nerve block versus spinal anesthesia

2021 ◽  
Vol 6 (2) ◽  
pp. 148-152
Author(s):  
Seray Turkmen ◽  
◽  
Mehmet Mutlu
Keyword(s):  
Peripheral Nerve ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroscopy ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Surgeon Satisfaction

Objective. This study aims to compare two different methods of regional anesthesia applied for knee arthroscopy in terms of patient and surgeon satisfaction. Materials and Methods. Eighty patients who underwent knee arthroscopy either with spinal anesthesia (SA) or unilateral sciatic and femoral nerve block (SFNB) were included in the study. A nurse conducted a blind study questionnaire to assess the surgeon and patient satisfaction from anesthesia performed at the end of the surgery. Pain score, demographical data, duration of surgery, motor and sensory block duration, time of first rescue analgesia were recorded and analyzed statistically. Results. A statistically significant difference was found between the patient (p = 0.001; p <0.01) and surgeon (p = 0.022; p <0.05) satisfaction rates, these being lower in the group with SFNB comparable to patients with spinal anesthesia. There was a statistically significant difference between the first analgesic requirements of the patients according to the groups (p = 0.001; p <0.01). The first analgesic requirement of the patients who received SFNB was later than in the case of patients who received spinal anesthesia. Conclusions. Patient and surgeon satisfaction with SA was significantly higher than SFNB. The peripheral nerve blocks are inadequate for patient and surgeon satisfaction for knee arthroscopy compared to SA.

Comparison of spinal anesthesia with combined sciatic-femoral nerve block for outpatient knee arthroscopy

2008 ◽  
Vol 20 (6) ◽  
pp. 415-420 ◽  
Author(s):  
Felix R. Montes ◽  
Eduardo Zarate ◽  
Reinaldo Grueso ◽  
Juan C. Giraldo ◽  
Maria P. Venegas ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroscopy ◽  
Femoral Nerve Block ◽  
Femoral Nerve

scholarly journals The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932199663
Author(s):  
Mustafa Kaçmaz ◽  
Zeynep Yüksel Turhan
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Significant Difference ◽  
Total Knee

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

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 Ultrasound Guided Femoral Nerve Block with Bupivacaine versus Bupivacaine and Tramadol for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty under Spinal Anesthesia

2021 ◽  
pp. 23-32
Author(s):  
Mohammad Mostafa Abo Farrag ◽  
Laila Elahwal ◽  
Hesham Mohammad Maroof ElDomairy ◽  
Mohammad Ibrahem Okab
Keyword(s):  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Group I ◽  
Total Knee

Background: Effective pain control in Total knee arthroplasty (TKA) is important for optimizing the rehabilitation process in order to achieve patient satisfaction with a good functional outcome as well as reduce hospitalization duration and costs. Combined use of aesthetic with tramadol has been reported to achieve a longer duration of sensory and motor block. The aim of this study is to evaluate the quality and duration of postoperative analgesia produced by ultrasound guided femoral nerve block (FNB) by bupivacaine versus (bupivacaine & tramadol) in patients undergoing total knee arthroplasty under spinal anesthesia. Methods: This prospective randomized controlled double blinded study was carried out on 60 patients aged above 50 years; American Society of Anesthesiologists physical status (ASA) I-III scheduled for total knee arthroplasty under spinal anesthesia. Patients were randomized to one of two equal groups: Group I control (C): received FNB with 30 ml 0.25% bupivacaine. Group II tramadol (T): received FNB with 30ml 0.25% bupivacaine and 100 mg tramadol. Results: Postoperative heart rate was significantly increased in group C than group T at 8h, 12h, 16h and 24h. Postoperative mean arterial blood pressure was significantly increased in group C than group T at 6h, 8h, 12h, 16h and 24h. There were 30 (100%) patients required rescue analgesia in group C and 19 (63.33%) patients in group T which was increased significantly in group C than group T. The time to first analgesic requirement was significantly decreased in group C than group T. Total morphine consumption was increased significantly in group C than group T. VAS was increased significantly in group C than group T at 6, 8, 12, 16 and 24 hours. Adverse effects were insignificantly different between both groups. Conclusion: Adding tramadol (100 mg) to 0.25% bupivacaine (to a volume of 30 ml) during US guided FNB of TKA under spinal anesthesia was associated with better postoperative analgesia when compared with 0.25% bupivacaine alone.

scholarly journals A Pilot Randomised Clinical Trial of 3-In-1 Femoral Nerve Block and Intravenous Morphine as Primary Analgesia for Patients Presenting to the Emergency Department with Fractured Hip

2008 ◽  
Vol 15 (4) ◽  
pp. 205-211 ◽  
Author(s):  
CA Graham ◽  
K Baird ◽  
AC McGuffie
Keyword(s):  
Emergency Department ◽  
Pain Score ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Wilcoxon Test ◽  
Block Group ◽  
Pain Scores ◽  
Significant Difference ◽  
Median Pain

Background Fractured neck of femur (NOF) is a leading cause of morbidity and mortality in the elderly. Published clinical guidelines suggest early adequate analgesia as a key management aim. The femoral nerve ‘3-in-1 block’ has previously been shown to provide effective analgesia for these patients in the peri- and post-operative phase of care. The aim of this study was to examine the use of the ‘3-in-1’ femoral nerve block as primary analgesia for patients with a fractured NOF presenting to the emergency department. Methods This was a single centre pragmatic randomised controlled open-label trial comparing femoral nerve block (using a ‘3-in-1’ technique) with intravenous (IV) morphine. A convenience sample of patients presenting to the emergency department of a district general hospital with a clinically or radiologically suspected fractured NOF were recruited. They were randomised to receive either 0.1 mg/kg IV bolus of morphine or a ‘3-in-1’ femoral nerve block with 30 ml of 0.5% plain bupivacaine. Visual analogue pain scores were noted prior to treatment and at 30 minutes, 2 hours, 6 hours and 12 hours after treatment. Immediate complications such as vascular puncture or the requirement for naloxone were noted. Results Forty patients were recruited, 22 patients were randomised to IV morphine and 18 patients were randomised to ‘3-in-1’ femoral nerve block. Complete data were available for 33 patients. There was no significant difference in initial median pain score (p=0.45). Analysis using the Wilcoxon test showed a significant decrease in pain score for the morphine group (p=0.01) and the nerve block group (p<0.01) at 30 minutes compared with baseline. Analysis using the Mann-Whitney U test between median pain scores at each time point showed a significant lower pain score in the nerve block group at 30 minutes (p=0.046). There were no immediate complications in either group. Conclusion Our results suggest that a ‘3-in-1’ femoral nerve block is at least as effective as IV morphine when used as primary analgesia for patients with fractured NOF. Our results suggest that the femoral nerve block may provide better analgesia at 30 minutes. Further larger scale randomised trials are warranted.

scholarly journals Liposome Bupivacaine Femoral Nerve Block for Postsurgical Analgesia after Total Knee Arthroplasty

2016 ◽  
Vol 124 (6) ◽  
pp. 1372-1383 ◽  
Author(s):  
Admir Hadzic ◽  
Harold S. Minkowitz ◽  
Timothy I. Melson ◽  
Richard Berkowitz ◽  
Anna Uskova ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Least Squares ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Patient Controlled Analgesia ◽  
Rescue Analgesia ◽  
Liposome Bupivacaine ◽  
Total Knee

Abstract Background The authors evaluated the efficacy of liposome bupivacaine in a femoral nerve block (FNB) after total knee arthroplasty. Methods Part 1: subjects received FNB with 20 ml liposome bupivacaine (67, 133, or 266 mg) or placebo. Part 2: subjects were randomized to FNB with liposome bupivacaine 266 mg or placebo. The primary outcome measure was area under the curve of the numeric rating scale score for pain intensity at rest through 72 h (AUC NRS-R0–72) with imputed scores after rescue medication. Results In part 1, FNB with liposome bupivacaine 266 mg (n = 24) resulted in analgesia similar to that obtained with 133 mg and was chosen for part 2. In part 2, least-squares mean (standard error) AUC NRS-R0–72 was lower with liposome bupivacaine 266 mg (n = 92) than with placebo (n = 91; 419 [17] vs. 516 [17]; P &lt; 0.0001). This outcome remained unchanged in a post hoc analysis without score imputation (221 [12] vs. 282 [12]; P = 0.0005). Least-squares mean AUC NRS-R with imputed scores was lower with liposome bupivacaine during each 24-h interval (0 to 24, 24 to 48, and 48 to 72 h) after surgery; AUC NRS-R without imputed scores was lower during the 0- to 24-h and 24- to 48-h intervals. The liposome bupivacaine group had lower mean total opioid use (76 vs. 103 mg morphine; P = 0.0016). Pain was sufficiently severe to require second-step rescue with opioids via intravenously administered patient-controlled analgesia in 92% of liposome bupivacaine patients and 81% of placebo patients. With patient-controlled analgesia and other forms of rescue analgesia, mean NRS scores with activity were moderate in both liposome bupivacaine and placebo groups throughout the part 2 study period. Incidence of adverse events was similar between the groups (part 1: 90 vs. 96%; part 2: 96 vs. 96%, respectively). Conclusion FNB with liposome bupivacaine (266 mg) resulted in modestly lower pain scores and reduced opioid requirements after surgery, with an adverse event profile similar to placebo.

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