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Anesth Analg ; 108(4): 1296-302, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19299803

RESUMO

BACKGROUND: We previously reported that continuous perineural femoral analgesia reduces pain with movement during the first 2 days after anterior cruciate ligament reconstruction (ACLR, n = 270), when compared with multimodal analgesia and placebo perineural femoral infusion. We now report the prospectively collected general health and knee function outcomes in the 7 days to 12 wk after surgery in these same patients. METHODS: At three points during 12 wk after ACLR surgery, patients completed the SF-36 General Health Survey, and the Knee Outcome Survey (KOS). Generalized Estimating Equations were implemented to evaluate the association between patient-reported survey outcomes and (1) preoperative baseline survey scores, (2) time after surgery, and (3) three nerve block treatment groups. RESULTS: Two hundred seventeen patients' data were complete for analysis. In univariate and multiple regression Generalized Estimating Equations models, nerve block treatment group was not associated with SF-36 and KOS scores after surgery (all with P > or = 0.05). The models showed that the physical component summary of the SF-36 (P < 0.0001) and the KOS total score (P < 0.0001) increased (improved) over time after surgery and were also influenced by baseline scores. CONCLUSIONS: After spinal anesthesia and multimodal analgesia for ACLR, the nerve block treatment group did not predict SF-36 or knee function outcomes from 7 days to 12 wk after surgery. Further research is needed to determine whether these conclusions also apply to a nonstandardized anesthetic, or one that includes general anesthesia and/or high-dose opioid analgesia.


Assuntos
Analgesia/métodos , Analgésicos Opioides/administração & dosagem , Raquianestesia , Ligamento Cruzado Anterior/cirurgia , Nervo Femoral , Articulação do Joelho/cirurgia , Bloqueio Nervoso , Procedimentos Ortopédicos , Adulto , Ligamento Cruzado Anterior/inervação , Ligamento Cruzado Anterior/fisiopatologia , Cateterismo , Feminino , Humanos , Infusões Parenterais , Articulação do Joelho/inervação , Articulação do Joelho/fisiopatologia , Masculino , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Recuperação de Função Fisiológica , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
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