Health-Related Quality of Life After Tricompartment Knee Arthroplasty With and Without an Extended-Duration Continuous Femoral Nerve Block: A Prospective, 1-Year Follow-Up of a Randomized, Triple-Masked, Placebo-Controlled Study
| Autor: | Krista Vandenborne, Rosalita C. Maldonado, Linda T. Le, Edward R. Mariano, Daniel I. Sessler, Peter F. Gearen, Brian A. Williams, F. Kayser Enneking, Jonathan J. Shuster, Pamela W. Duncan, Brian M. Ilfeld, R. Scott Meyer |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Time Factors WOMAC medicine.medical_treatment Drug Administration Schedule Article Catheterization Disability Evaluation Femoral nerve medicine Humans Infusion pump Ropivacaine Prospective Studies Anesthetics Local Arthroplasty Replacement Knee Infusion Pumps Pain Measurement Analgesics Pain Postoperative business.industry Area under the curve Nerve Block Recovery of Function Osteoarthritis Knee Amides Arthroplasty Surgery Catheter Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Quality of Life Nerve block business Femoral Nerve Follow-Up Studies medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 108:1320-1325 |
| ISSN: | 0003-2999 |
| Popis: | BACKGROUND: We previously provided evidence that extending an overnight continuous femoral nerve block to 4 days after tricompartment knee arthroplasty (TKA) provides clear benefits during the perineural infusion in the immediate postoperative period. However, it remains unknown if the extended infusion improves subsequent health-related quality of life between 7 days and 12 mo. METHODS: Patients undergoing TKA received a femoral perineural infusion of ropivacaine 0.2% from surgery until the following morning, at which time patients were randomized to either continue perineural ropivacaine (n 25) or normal saline (n 25) in a double-masked fashion. Patients were discharged with their catheter and a portable infusion pump, and catheters were removed on postoperative day 4. Health-related quality of life was measured using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index preoperatively and then at 7 days, as well as 1, 2, 3, 6, and 12 mo after surgery. The WOMAC evaluates three dimensions of health-related quality of life: pain, stiffness, and physical functional disability. For inclusion in the analysis, we required a minimum of 4 of the 6 time points, including day 7 and at least 2 of mo 3, 6, and 12. RESULTS: The two treatment groups had similar WOMAC scores for the mean area under the curve calculations (point estimate for the difference in mean area under the curve for the two groups [overnight infusion groupextended infusion group] 1.2, 95% confidence interval: 5.6 to 8.0; P0.72) and at all individual time points (P0.05). CONCLUSIONS: We found no evidence that extending an overnight continuous femoral nerve block to 4 days improves (or worsens) subsequent health-related quality of life between 7 days and 12 mo after TKA. (ClinicalTrials.gov number, NCT00135889.) (Anesth Analg 2009;108:1320‐5) |
| Databáze: | OpenAIRE |
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