ABSTRACT
To investigate the efficacy of single injection femoral nerve block [FNB] on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty [TKA]. We conducted this prospective, randomized, blinded trial in the Department of Orthopedics and Traumatology, Hacettepe University Hospital Ankara, Turkey, between June 2003 and April 2004. Twenty-three patients scheduled for elective TKA were randomly divided into 3 groups. Group I received preemptive single injection FNB, group II received postoperative single injection FNB, and group III served as a control group. Intravenous morphine patient controlled analgesia [PCA] was used following surgery in all groups. Morphine dose and pain score defined by the visual analog scale [VAS] were recorded postoperatively at the 15th minute, 30th minute, 1st, 4th, 6th, 12th, 24th, and 48th hours. A standard rehabilitation protocol was applied for all patients. The independence level in functional activities was assessed during the first 2 postoperative days and at discharge with the Iowa Level of Assistance Scale [ILAS] and the Iowa Ambulation Speed Scale [IASS]. Physical therapists that enrolled in the study were blinded to the groups. Pain scores were significantly different between the groups [p<0.05]. The preemptive and postoperative FNB group's VAS scores were both significantly lower than the control group [p<0.05]. However, there was no significant difference in VAS scores between preemptive and postoperative FNB groups [p>0.05]. There was no statistically significant difference between the groups in any of the functional scores in the first 2 postoperative days, and at discharge [p>0.05]. Single injection FNB provided effective analgesia in patients undergoing TKA. However, the independence level in functional activities in the early postoperative period was not influenced by the analgesia method