Effective concentration of Ropivacaine for post-operative pain relief in Total knee replacement surgeries using ultra sound guided continuous femoral block – A randomized double blinded study

2016 ◽  
Vol 3 (3) ◽  
pp. 368
Author(s):  
A. Radhakrishnan ◽  
R Krishna Prabu
Keyword(s):  
Pain Relief ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Effective Concentration ◽  
Ultra Sound ◽  
Post Operative Pain ◽  
Blinded Study ◽  
Total Knee ◽  
Double Blinded ◽  
Continuous Femoral Block

scholarly journals Adductor canal block to manage flexion contracture deformity (FCD) of knee before total knee replacement (TKR) ‐ a case report

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Jadon Ashok ◽  
Sudarshan Pavan ◽  
Sinha Neelam ◽  
Chakraborty Swastika
Keyword(s):  
Pain Relief ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Continuous Infusion ◽  
Knee Replacement ◽  
Flexion Contracture ◽  
Lower Limbs ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Total Knee

Abstract Background The fixed contracture deformity (FCD) which is often present in patients awaiting total knee replacement (TKR) affects the surgical outcome. Therefore, it is necessary to reduce the severity of the FCD before the TKR surgery. Physiotherapy, including active stretching and exercise to increase range of motion are commonly practiced techniques. However, due to the presence of pain, patients are often unable to cooperate and perform exercise up-to the desired levels. We used continuous adductor canal block (CACB) in two patients with severe FCD scheduled for TKR surgery to decrease their pain during physiotherapy and to help them in increasing their range of motion to achieve early fitness for surgery. This approach is not documented and published earlier in the medical literature. Case presentation Two female patients aged 58 and 68 years were scheduled for TKR surgery with severe flexion contracture deformity of both limbs (70°–90°). Due to severe contracture deformity surgeon suggested improvement in ROM before surgery. Ultrasound-guided adductor canal block was given, and catheters were inserted in the adductor canal. Continuous infusion of local anesthetic and bolus injection before active stretching was given. Both patients had good pain relief in existing arthritic pain and pain during active stretching. The flexion deformity was reduced in both the patients up to 30°. The technique of adductor can block with continuous infusion also provided excellent postoperative analgesia and helped in early mobilization without affecting the muscle strength of lower limbs. Conclusion In two patients of severe flexion contracture deformity, the continuous adductor canal block helped to reduce the degree of deformity before the total knee replacement surgery. It also provided excellent pain relief in postoperative pain and helped in early postoperative mobilization without muscle weakness.

266. A Study of Two Different Doses of Levobupivacaine in Continuous Femoral Block in Total Knee Replacement

2008 ◽  
Vol 33 (Suppl 1) ◽  
pp. e90.2-e90
Author(s):  
E. Antonopoulou ◽  
A. Tataraki ◽  
S. Poulaki ◽  
M. Papadopoulou ◽  
G. Digas ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee ◽  
Continuous Femoral Block ◽  
Different Doses

scholarly journals Local infiltration of analgesia and tranexamic acid is safe and efficacious in reducing blood loss and comparable to intra-articular tranexamic acid in total knee replacements

2021 ◽  
Author(s):  
H Sivasubramanian ◽  
CMP Tan ◽  
L Wang
Keyword(s):  
Pain Relief ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Knee Replacement ◽  
Functional Outcomes ◽  
Primary Total Knee Replacement ◽  
Total Knee ◽  
The Mean ◽  
Primary Total Knee

Introduction: The use of peri-articular (PA) tranexamic acid (TXA) and its efficacy in comparison with intra-articular (IA) tranexamic acid has not been well explored in literature. This retrospective cohort study aims to compare the effects of IA and PA TXA with analgesic components in reducing blood loss and improving immediate post-operative pain relief and functional outcomes in unilateral primary total knee replacement (TKA) patients. Methods: 63 patients who underwent a unilateral primary total knee replacement procedure were divided into 2 groups: 42 patients in the IA TXA delivery group, 21 patients in the PA TXA group. 1g of TXA was utilized for all patients. All patients had pericapsular infiltration consisting of 0.5ml of Adrenaline, 0.4ml of Morphine, 1g of Vancomycin, 1ml of Ketorolac and 15ml of Ropivacaine. Outcomes for blood loss, and surrogate markers for immediate functional recovery were measured. Results: 54.0% of the patients were female, 46.0% male. The mean drop in post-operative Hb levels in the PA and IA group was 2.0g/dL and 1.6 g/dL respectively, and statistically insignificant (p=0.10). The mean HCT drop in the PA and IA group was 6.1% and 5.3% respectively and statistically insignificant (p=0.58). The POD 1 and discharge day flexion angles, POD 1 and POD 2 VAS scores, gait distance on discharge, and length of hospitalization stay were largely similar in both groups. Conclusion: Our study shows that both IA and PA TXA with analgesic components are equally efficient in reducing blood loss and improving immediate postoperative pain relief and functional outcomes.

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