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Angelini A, Parise GM, Cerchiaro M, Ambrosio F, Navalesi P, Ruggieri P. Sublingual Sufentanil Tablet System (SSTS-Zalviso ®) for Postoperative Analgesia after Orthopedic Surgery: A Retrospective Study. J Clin Med 2022; 11:jcm11226864. [PMID: 36431339 PMCID: PMC9698499 DOI: 10.3390/jcm11226864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/08/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The aim of this study is to compare sublingual sufentanil and the administration device for its delivery (SSST-Zalviso®) with the traditional strategies used for the control of postoperative pain to establish if there is an actual benefit for the patient and healthcare personnel. Materials and Methods: A retrospective study was conducted to compare the efficacy of SSTS in the management of postoperative pain after orthopedic surgery between October 2018 and June 2020. We analyzed 50 patients who underwent a total knee arthroplasty (TKA). The control group consisted of 21 patients who underwent TKA and during the hospitalized recovery received a continuous femoral nerve block (cFNB). The statistical study was conducted with a level of significance p = 0.05 using “U” test, Mann−Whitney, to verify if patients had a better control of pain and fewer calls for rescue analgesia. Results: Patients involved in the study showed a significant reduction in pain intensity with the use of SSTS in the 24 h following surgery (p = 0.0568), also a drastic drop of the calls for rescue analgesia (p < 0.0001) reduces the number of calls for its control. Conclusions: This study demonstrates how SSTS might reduce pain intensity in the first 24 h after surgery and reduce the number of calls for its control, indicating better analgesic coverage and implying reduced interventions from healthcare personnel. This could allow a redistribution of resources and a reduction in the use of analgesic drugs in wards where the SSTS is used.
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Affiliation(s)
- Andrea Angelini
- Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-04-9821-3311 or +39-33-3442-0795
| | - Gian Mario Parise
- Institute of Anesthesiology and Critical Care, Department of Medicine-DIED, University of Padova, 35128 Padova, Italy
| | - Mariachiara Cerchiaro
- Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy
| | - Francesco Ambrosio
- Institute of Anesthesiology and Critical Care, Department of Medicine-DIED, University of Padova, 35128 Padova, Italy
| | - Paolo Navalesi
- Institute of Anesthesiology and Critical Care, Department of Medicine-DIED, University of Padova, 35128 Padova, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy
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Gola W, Bialka S, Zajac M, Misiolek H. Cardiac Arrest after Small Doses Ropivacaine: Local Anesthetic Systemic Toxicity in the Course of Continuous Femoral Nerve Blockade. Int J Environ Res Public Health 2022; 19:12223. [PMID: 36231524 PMCID: PMC9566458 DOI: 10.3390/ijerph191912223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The paper presents a case report of an episode of local anesthetic systemic toxicity (LAST) with cardiac arrest after continuous femoral nerve blockade. CASE REPORT A 74-year-old patient burdened with hypertension and osteoarthritis underwent elective total knee replacement surgery. After surgery, a continuous femoral nerve blockade was performed and an infusion of a local anesthetic (LA) was started using an elastomeric pump. Five hours after surgery, the patient had an episode of generalized seizures followed by cardiac arrest. After resuscitation, spontaneous circulation was restored. In the treatment, 20% lipid emulsion was used. On day two of the ICU stay, the patient was fully cardiovascularly and respiratorily stable without neurological deficits and was discharged to the orthopedic department to continue treatment. CONCLUSION Systemic toxicity of LA is a serious and potentially fatal complication of the use of LA in clinical practice. It should be noted that in nearly 40% of patients, LAST deviates from the classic and typical course and may have an atypical manifestation, and the first symptoms may appear with a long delay, especially when continuous blockades are used. Therefore, the proper supervision of the patient and the developed procedure in the event of LAST is undoubtedly important here.
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Affiliation(s)
- Wojciech Gola
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Szymon Bialka
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Marek Zajac
- Department of Anesthesiology and Intensive Care, St. Lucas Hospital, 26-200 Konskie, Poland
| | - Hanna Misiolek
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Hattammaru Y, Mio Y, Hascilowicz T, Utsumi I, Murakami Y, Omi S. Reduction of leakage from insertion site during continuous femoral nerve block with catheter-through-needle versus catheter-over-needle technique for postoperative analgesia after total knee arthroplasty: a randomized controlled trial. BMC Anesthesiol 2022; 22:11. [PMID: 34986793 PMCID: PMC8728999 DOI: 10.1186/s12871-021-01554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Continuous femoral nerve block (CFNB) is a common procedure used for postoperative analgesia in total knee arthroplasty. Continuous nerve block using a conventional needle (catheter-through-needle/CTN) is complicated by leakage of the anesthetic from the catheter insertion site. A different type of needle (catheter-over-needle/ CON) is now available, which is believed to reduce leakage as the diameter of the catheter is larger than that of the needle. The purpose of this study was to compare the incidence of leakage from the catheter insertion site during CFNB while using CTN and CON for postoperative analgesia after total knee arthroplasty (TKA). METHODS This prospective, randomized, single-blinded controlled study included 60 patients who were scheduled for TKA at our facility between May 2016 and November 2017. Patients were randomly allocated to the CTN or CON groups. All patients in both groups received CFNB and sciatic nerve block for postoperative analgesia. The administration of 0.16% levobupivacaine mixed with 6 mg of indigo carmine (a dye added to easily identify leakage) was started at 6 ml/h at the end of surgery. The primary outcome was the incidence of leakage from the catheter insertion site. We further investigated the degree of leakage, the incidence of catheter migration, pain scores using the numerical rating scale at 48 h postoperatively, and the number of days until the operated knee could be flexed 120 degrees postoperatively in both groups. RESULTS The CON group had a significantly lower incidence and degree of leakage from the catheter insertion site. There were no significant differences in other measurement outcomes. CONCLUSIONS Use of CON reduces the incidence of leakage from the catheter insertion site during CFNB in the use of postoperative analgesia for total knee arthroplasty. Future research is needed to determine additional benefits of using CON related to decreased leakage. TRIAL REGISTRATION The study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry ( UMIN000021537 ), prospectively registered on 18 March 2016.
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Affiliation(s)
- Yoshiyasu Hattammaru
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yasushi Mio
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Tomasz Hascilowicz
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Isao Utsumi
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yuichi Murakami
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Sachiko Omi
- Department of Anesthesiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yan SC, Fu SX, Li N, Mai L. Comparison of analgesic effects and postoperative cognitive function following total knee arthroplasty: continuous intravenous infusion of fentanyl vs. ultrasound-guided continuous femoral nerve block with ropivacaine. Am J Transl Res 2021; 13:3174-3181. [PMID: 34017486 PMCID: PMC8129300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of continuous intravenous infusions (CII) of fentanyl by pumping and ultrasound-guided continuous femoral nerve block (CFNB) with ropivacaine in terms of analgesic effects and postoperative cognitive function following total knee arthroplasty. METHODS The clinical data of 103 patients who underwent total knee arthroplasty were collected retrospectively and divided into group A (n = 51) receiving CII of fentanyl by pumping and group B (n = 52) receiving CFNB with ropivacaine. Mini-Mental State Examination (MMSE) scores, Visual analog scale (VAS) scores, knee joint flexion angle (KJFA), muscle strength, postoperative cognitive dysfunction (POCD), patient satisfaction, and adverse reactions of the two groups were compared. RESULTS The muscle strength scores in group B gradually improved at 6-48 h as compared with at 4 hours after operation (P < 0.05). Compared with group A, patients in group B had greater active motion of KJFA at 4, 6, and 12 h after operation (P < 0.05). In contrast to group A, patients in group B had lower VAS scores at rest or active and passive motion at 4-48 h after operation (P < 0.05). The MMSE scores of group B were higher than those of group A at 1, 4, and 7 d after operation (P < 0.05). The incidence of POCD at 4 d after operation was 1.92% in group B, lower than that of 15.69% in group A (P < 0.05). The incidence of adverse reactions was 5.77% in group B, lower than that of 29.41% in group A (P < 0.05). The satisfaction scores of group B were higher than those of group A (P < 0.05). CONCLUSION Compared with CII of fentanyl by pumping, ultrasound-guided CFNB showed superior analgesic effects following total knee arthroplasty, which should reduce the incidence of POCD and adverse reactions.
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Affiliation(s)
- Shun-Chang Yan
- Department of Anesthesiology, Hainan General HospitalHaikou 570000, Hainan Province, China
| | - Sheng-Xin Fu
- Department of Ultrasound, Hainan General HospitalHaikou 570000, Hainan Province, China
| | - Na Li
- Department of Anesthesiology, Hainan General HospitalHaikou 570000, Hainan Province, China
| | - Lian Mai
- Department of Anesthesiology, Hainan General HospitalHaikou 570000, Hainan Province, China
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Marino J, Scuderi G, Dowling O, Farquhar R, Freycinet B, Overdyk F. Periarticular Knee Injection With Liposomal Bupivacaine and Continuous Femoral Nerve Block for Postoperative Pain Management After Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2019; 34:495-500. [PMID: 30583813 DOI: 10.1016/j.arth.2018.11.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/29/2018] [Accepted: 11/19/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Local periarticular infiltration (PAI) analgesia has emerged as an important component of multimodal approaches to treat total knee arthroplasty postoperative pain. Liposomal bupivacaine may provide prolonged analgesic duration when injected into the surrounding tissues. The purpose of this study was to compare the analgesic efficacy and serum bupivacaine levels of a continuous femoral nerve block (CFNB) with bupivacaine to PAI with liposomal bupivacaine. METHODS Sixty-five patients undergoing primary unilateral total knee arthroplasty were randomized into 2 groups: (1) CFNB and PAI with bupivacaine (CFNB group) or (2) PAI with bupivacaine:liposomal bupivacaine mixture at the end of surgery (LB group). The primary outcome was pain intensity at maximum knee flexion 24 hours following surgery. Secondary outcomes included pain intensities at rest and movement at timed intervals and serum bupivacaine levels. RESULTS Patients in the CFNB group experienced lower pain scores at maximum knee flexion at 24 hours (7.91; 95% confidence interval, 7.19-8.61) compared to the LB group (8.95; 95% confidence interval, 8.42-9.48; P = .02). The mean peak serum bupivacaine level in the LB group up to 72 hours was 0.55 μg/mL versus 1.4 μg/mL for CFNB group (P = .0008) with one patient in the CFNB group exceeding the reported minimum serum bupivacaine threshold for toxicity. CONCLUSION While similar pain control was observed on the day of surgery for both groups, patients with a CFNB experienced lower pain intensities during maximum knee flexion at 24 hours. Total serum concentrations in LB group remained below the toxicity threshold over the study period.
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Affiliation(s)
- Joseph Marino
- Department of Anesthesiology, Zucker School of Medicine, Long Island Jewish Valley Stream, Valley Stream, NY
| | - Giles Scuderi
- Orthopedic Service Line, Northwell Health, New York, NY
| | - Oonagh Dowling
- Department of Anesthesiology, Zucker School of Medicine, New Hyde Park, NY
| | - Rena Farquhar
- Department of Anesthesiology, Zucker School of Medicine, Northwell Health, Long Island Jewish Valley Stream, Valley Stream NY
| | - Bridget Freycinet
- Department of Anesthesiology, Zucker School of Medicine, Northwell Health, Long Island Jewish Valley Stream, Valley Stream NY
| | - Frank Overdyk
- Department of Anesthesiology, Trident Anesthesiology Group, Charleston, SC
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Gandhi HJ, Trivedi LH, Tripathi DC, Dash DM, Khare AM, Gupta MU. A randomized, controlled trial of comparison of a continuous femoral nerve block (CFNB) and continuous epidural infusion (CEI) using 0.2% ropivacaine for postoperative analgesia and knee rehabilitation after total knee arthroplasty (TKA). J Anaesthesiol Clin Pharmacol 2019; 35:386-389. [PMID: 31543590 PMCID: PMC6748000 DOI: 10.4103/joacp.joacp_134_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and Aims: Postoperative pain relief following total knee arthroplasty (TKA) is a major concern as it will help to achieve an effective functional outcome. The present study was conducted to compare continuous femoral nerve block (CFNB) and continuous epidural infusion (CEI) techniques using ropivacaine. Material and Methods: Forty patients were randomly allocated into group F and group E to receive 0.2% ropivacaine through femoral catheter or epidural catheter respectively. An infusion was started @6 ml/h post-operatively when VAS was ≥4. The dose was titrated to keep VAS <4 (with minimum rate 2 ml/h and maximum rate 10 ml/h). If VAS ≥4 occurred despite maximum rate of infusion, a rescue analgesic was given. Primary objectives were to compare visual analogue score (VAS), rehabilitation indices, and rescue analgesic requirement. Secondary objectives were to assess patient and surgeon's satisfaction score, motor blockade, and complications if any. Results: The mean VAS score, rehabilitation goals, rescue analgesic requirement, and patient's and surgeon's mean satisfaction scores were comparable in both the groups. Motor blockade was not seen and though the number of side effects were more in group E, they did not achieve statistical or clinical significance. Conclusion: CFNB can be used as an alternative, effective postoperative analgesic technique for TKA.
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Affiliation(s)
- Harshil J Gandhi
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
| | - Lopa H Trivedi
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
| | - Deepshikha C Tripathi
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
| | - Deepika M Dash
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
| | - Amit M Khare
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
| | - Mayur U Gupta
- Department of Anaesthesiology, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India
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Büttner B, Dracklé J, Kristof K, Hinz J, Schwarz A, Bauer M, Mansur A, Bergmann I. Paths of femoral nerve catheters placed using ultrasound-guided in plane vs out of plane techniques: A randomized controlled clinical trial. Medicine (Baltimore) 2018; 97:e12958. [PMID: 30412115 PMCID: PMC6221616 DOI: 10.1097/md.0000000000012958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Continuous blockade of the femoral nerve is widely used for postoperative analgesia after hip surgery. It can be achieved by ultrasound-guided placement of a femoral nerve catheter via either the in plane (IP) or out of plane (OOP) technique. On the basis of postoperative radiographs, we evaluated the paths of femoral nerve catheters with respect to both techniques and its effect on postoperative analgesia. METHODS Thirty-four patients were randomized to receive a radiopaque femoral nerve catheter via either the IP or OOP technique. The paths and tip position of the catheters were evaluated in postoperative frontal radiographs of the operated hip joint concerning a predefined target region and four neighboring regions. Pain scores were assessed using a numeric rating scale (0-10). RESULTS Sixteen IP patients and 18 OOP patients were included in the study. The catheter path was radiographically evaluated in 13 IP patients and in 10 OOP patients. The catheter tips were located within the target region in 39% of the IP group and in 50% of the OOP group. The catheter tip was 0.00 cm [-3.80 to 3.84] and -1.19 cm [-12.27 to 0.00] (median [range]) from the target region in the OOP group and IP group, respectively (P = .045). Catheters flipped distally more often in the IP group (IP: 61.5%, OOP: 10.0%; P = .01). There were no marked differences in the pain scores of either group. CONCLUSION Femoral nerve catheters inserted by the ultrasound-guided IP technique flip distally more frequently than catheters inserted by the OOP technique. Moreover, the distance between the catheter tip and the trunk of the femoral nerve is greater for IP catheters than for OOP catheters. Despite these findings, postoperative analgesia did not seem to differ between the 2 techniques.
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Affiliation(s)
- Benedikt Büttner
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen
| | - Joschka Dracklé
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen
| | - Katalin Kristof
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen
| | - José Hinz
- Department of Anesthesiology, Emergency and Intensive Care Medicine, Klinikum Region Hannover, Hannover
| | - Alexander Schwarz
- Department of Neuroradiology, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Martin Bauer
- Department of Anesthesiology, Emergency and Intensive Care Medicine, Klinikum Region Hannover, Hannover
| | - Ashham Mansur
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen
| | - Ingo Bergmann
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen
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Abstract
INTRODUCTION The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). METHODS AND MATERIALS Patients were identified from the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010. RESULTS Three hundred sixty-six hip fracture patients had cFNB. The mean time with cFNB was 3.4 days. There were no significant differences in gender, length of stay, time to surgery, mortality rate, in-hospital falls, or resurgery rates during admission between the 2 groups. The nFNB group had an insignificant higher use of morphine as needed during the first 5 days of admission (nFNB: 53.1 mg, 95% confidence interval [CI]: 34.4-71.7; cFNB: 47.7 mg, 95% CI: 40.7-64.3; P = .54) and during the whole admission (cFNB: 34.3 mg, 95% CI: 23.2-45.5; cFNB: 30.3 mg, 95% CI: 26.6-33.0; P = .4). Some 8.47% of the total morphine consumption during admission was morphine as needed for the nFNB group and 9.89% for the cFNB group. CONCLUSION Patients with cFNB did only have a marginally lower opioid usage during admission when compared to patients without the block, with no significance between the 2 groups. This could indicate that the cFNB is an ineffective analgesic strategy, especially in the postoperative period, but larger randomized studies are needed in order to clarify this.
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Affiliation(s)
- Ida Helsø
- Department of Orthopaedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christopher Jantzen
- Department of Orthopaedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jes Bruun Lauritzen
- Department of Orthopaedic Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Al-Zahrani T, Doais KS, Aljassir F, Alshaygy I, Albishi W, Terkawi AS. Randomized clinical trial of continuous femoral nerve block combined with sciatic nerve block versus epidural analgesia for unilateral total knee arthroplasty. J Arthroplasty 2015; 30:149-54. [PMID: 25149364 DOI: 10.1016/j.arth.2014.07.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 07/02/2014] [Accepted: 07/28/2014] [Indexed: 02/01/2023] Open
Abstract
Pain control following total knee arthroplasty (TKA) is crucial to hasten rehabilitation and decrease morbidity. We evaluated whether there is a difference between epidural infusion and continuous femoral nerve block with respect to postoperative pain control and rehabilitation course. Fifty patients completed the study. There was no statistically significant difference in the pain scores (P=0.33), morphine consumption (P=0.09) mean blood pressure or heart rate (P=0.957, and P=0.716) between groups. The postoperative daily mobilization (P=0.80), knee joint range of motion (P=0.83), and straight leg test (P=0.99) were also similar between both groups. Patients were highly satisfied with their pain management in both groups without statistically significant difference (P=0.98).
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Affiliation(s)
- Tariq Al-Zahrani
- Department of Anesthesiology, King Saud University, Riyadh, Saudi Arabia
| | - Khaled S Doais
- Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fawzi Aljassir
- Department of Orthopedic, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Alshaygy
- Department of Orthopedic, King Saud University, Riyadh, Saudi Arabia
| | - Waleed Albishi
- Department of Orthopedic, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah S Terkawi
- Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia; Department of Anesthesiology, University of Virginia, Charlottesville, VA
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