Comparison of analgesic effect of femoral nerve block and continuous intravenous infusion pump, after anterior cruciate ligament reconstruction in first postoperative day

ABSTRACT

Incidence of anterior cruciate ligament [ACL] tearing is especially high in athletes, and reconstruction surgery is often required, associated with severe post-operative pain requiring active interventions. In the present study we compared the continuous intravenous morphine infusion technique with femoral nerve block regarding efficacy of pain management and patients' satisfaction, so that the best post-operative pain management for ACL reconstruction can be decided. We recruited 54 patients for this study and divided them randomly in 2 equal groups; Group-A [continuous intravenous morphine infusion] and Group-B [femoral nerve block]. Femoral block for coded subjects was performed at the end of the surgery right before shifting the patient. For patients in the other group, catheter was inserted for continuous infusion after extubation and transfer to recovery room. Pain intensity was assessed and recorded in recovery service and right after complete consciousness, and then every 4 hours by trained nurses of the department, using visual analogue scale [VAS]. After complete consciousness and every 12 hours, patients' satisfaction from post-operative analgesia was questioned and recorded, using five Likert scale items. Post-operative complication were recorded. The pain in Group-A [the continuous infusion pump group] at 20 and 24 hours after surgery was significantly lower than Group-B [nerve block group][p<0.05]. Post-operative complications [especially nausea] in femoral nerve block was lower. Analgesic degree of nerve block is comparable with the impact of continuous infusion pump at least during 20 hours after anterior cruciate ligament reconstruction surgery