A Comparison Of Femoral Nerve Block And Adductor Canal Block For Pain Management After Simultaneous Bilateral Total Knee Arthroplasty
Morressier, 2017
Online
unknown
Introduction: Although the efficacy of femoral nerve block (FNB) for pain after TKA has been reported, there is a risk of temporary weakness of quadriceps femoris muscle. Adductor canal block (ACB) has recently come under global spotlight as a procedure that does not cause weakness of quadriceps femoris muscle. The aim of this study, the efficacy of FNB was compared with that of ACB after simultaneous bilateral TKA.Subjects and Methods: This study examined 100 knees in 50 patients who underwent simultaneous bilateral TKA in a single institution between February and December 2017. Mean age of the patients (seven male and 43 female) was 78.8, and BMI was 26.5 kg/m2 at the time of surgery. One FNB injection was given in the right knee (group F), and one ACB injection in the left knee (group A), under ultrasonic guidance immediately after TKA. The drug used was 10 ml of 0.75% ropivacaine for each injection. In all cases, spinal anesthesis of 0.5% bupivacaine was applied prior to surgery. Intraoperatively, a mixture of 15 ml of 0.75% ropivacaine, 15 ml of epinephrine-containing 0.5% lidocaine, and 40 mg of triamcinolone acetonide was injected into the peri-articular region. The items assessed were as follows: hip joint flexion, positive/negative straight leg raising (SLR), and buckling at 5 h postoperatively; SLR, right-left difference in pain, and presence/absence of deep vein thrombosis (DVT) at 24 h postoperatively; knee extension and flexion angle at 3 and 5 days and 1, 2, and 3 weeks postoperatively; quadriceps femoris muscle strength at 1, 2, and 3 weeks postoperatively; and Knee Society Score (KSS) at 3 weeks postoperatively. Statistical analysis used t test and u03c72 test, and differences were regarded as significant at p < 0.05.Results: Although there was no difference in hip joint flexion at 5 h, the frequency of negative SLR was 4% in group A and 50% in group F ( p < 0.01 ), and the frequency of buckling was 2% in group A and 32% in group F ( p < 0.01 ), with both being significantly higher in group F. The frequency of negative SLR at 24 h was 4% in group A, but was also significantly higher 16%, in group F ( p = 0.046 ). The prevalence of pain at 24 h was 58% in group A and 52% in group F. DVT was found, at 24 h was 16% in group A and 24% in group F, showing no significant difference. There was also no significant difference in quadriceps femoris muscle strength (kgf), knee extension, or flexion angle (u00b0) (Table. 1). KSS improved in both groups except for the items
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A Comparison Of Femoral Nerve Block And Adductor Canal Block For Pain Management After Simultaneous Bilateral Total Knee Arthroplasty
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Autor/in / Beteiligte Person: | Yamamoto, Takao |
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Veröffentlichung: | Morressier, 2017 |
Medientyp: | unknown |
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