| Autor: |
Nassif Kalad, Remon Nadhy, Mahmoud Ali, Hoda Omar, Hussein Thabet, Wael Reda, Sayed Sharaf, Amr Gaber, Abdelghaffar Elsotouhy, Abdelrahman Mabrouk |
| Předmět: |
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| Zdroj: |
QJM: An International Journal of Medicine; 2024 Supplement, Vol. 117, pi34-i34, 1/2p |
| Abstrakt: |
Background: Total knee replacement (TKR) is considered a prevailing cause of severe postoperative pain and discomfort among orthopedic surgeries, limiting postoperative ambulation that is important for regaining joint function. Despite being the gold standard, epidural analgesia can be accompanied by diverse complications delaying postoperative ambulation and discharge from hospital. Continuous femoral nerve block (CFNB) and continuous adductor canal block (ACB) are reliable and efficacious regional anaesthesia techniques allowing better control of postoperative pain. This study purposed to compare epidural analgesia, continuous femoral nerve block & continuous adductor canal block regarding postoperative analgesia & incidence of postoperative complications. The aim of this study is to estimate the efficacy of epidural analgesia, continuous femoral nerve block & continuous adductor canal block regarding postoperative pain control following total knee replacement and the rate of incidence of associated postoperative complications. This is a prospective randomized controlled study where sixty patients were randomized into three equal groups, patients in group A received epidural analgesia, patients in group B received continuous femoral nerve block while patients in group C received continuous adductor canal block with postoperative continuous infusion of 0.125% bupivacaine with fentanyl 2 µg/ml in the three groups at a rate of 5 ml/hr. VAS score was assessed for 48 hours post-operatively and complications were recorded. Results: Epidural analgesia was superior to CFNB and ACB regarding postoperative pain control using visual analogue scale and postoperative pain control. CFNB and ACB are superior to epidural analgesia regarding postoperative ambulation and postoperative complications. Conclusions: Continuous epidural analgesia provides superior analgesia following total knee replacement than femoral nerve block and adductor canal block, with relatively more adverse effects like pruritus, post operative nausea, and vomiting (PONV). Both CFNB and ADB are good alternatives with fewer systemic side effects. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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