Continuous femoral nerve block versus intravenous patient-controlled analgesia for total knee replacement / 中国组织工程研究

ABSTRACT

BACKGROUND:In recent years, continuous femoral nerve block has been extensively used in total knee replacement, but there has a great dispute on the effect of analgesic mode in the clinic. OBJECTIVE:To compare the analgesic effects of continuous femoral nerve block and conventional intravenous patient-control ed analgesia in total knee arthroplasty. METHODS:A total of 50 cases treated with unilateral total knee arthroplasty in the Department of Orthopedics, Huaian First Hospital Affiliated to Nanjing Medical University from January 2014 to January 2015 were enrol ed in this study. Primary disease was osteoarthritis of the knee. They were randomly divided into two groups. Patients in the control group received intravenous patient-control ed analgesia, and those in the test group received continuous femoral nerve block analgesia. Postoperative pain Visual Analog Scale scores, adverse reactions and analgesic satisfaction score were compared between the two groups. RESULTS AND CONCLUSION:The Visual Analog Scale scores were significantly lower in the test group than in the control group at 4, 12, 24, 48 and 72 hours after surgery (P<0.05). The application rate of analgesic adjuvant drugs within 48-72 hours after surgery was significantly lower in the test group (4%) than in the control group (24%) (P<0.05). The incidence of complications was significantly lower in the test group (12%) than in the control group (48%) (P<0.05). The postoperative analgesic satisfaction rate was significantly higher in the test group (88%) than in the control group (60%) (P<0.05). Range of motion of the affected knee was significantly bigger in the test group than in the control group at 2, 3 and 4 days after replacement (P<0.05). Length of stay was significantly shorter in the test group than in the control group after surgery (P<0.05). These results suggest that multimodal continuous femoral nerve block analgesia has an ideal analgesic effect in total knee replacement. The incidence of adverse reactions is low. The analgesic satisfaction rate is high. Thus, it is an ideal analgesic method after total knee replacement.