Continuous femoral nerve block provides superior analgesia compared with continuous intra-articular and wound infusion after anterior cruciate ligament reconstruction
| Autor: | Pierpaolo Mariani, Alessandro Fabrizio Sabato, Eleonora Fabbi, Mario Dauri, S. Faria, Maria Beatrice Silvi, Roberta Carpenedo, Tatiana Sidiropoulou, Filadelfo Coniglione |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Anterior cruciate ligament reconstruction medicine.medical_treatment Settore MED/41 - Anestesiologia Injections Intra-Articular Catheters Indwelling Orthopedic Procedures Ropivacaine Prospective Studies Anterior Cruciate Ligament device Infusion Pumps Pain Measurement clinical article Morphine Local anesthetic Patellar ligament article analgesia clinical trial Nerve Block General Medicine Middle Aged continuous infusion musculoskeletal system Sciatic Nerve medicine.anatomical_structure priority journal Anesthesia Female Sciatic nerve postoperative pain Femoral Nerve medicine.drug Adult medicine.medical_specialty Adolescent medicine.drug_class Anterior cruciate ligament Clonidine Young Adult Femoral nerve Patellar Ligament medicine Humans controlled study human business.industry anterior cruciate ligament reconstruction visual analog scale postoperative analgesia adult female femoral nerve male nerve block Plastic Surgery Procedures Amides Surgery Anesthesiology and Pain Medicine Nerve block business Ketorolac |
| Zdroj: | Regional anesthesia and pain medicine. 34(2) |
| ISSN: | 1532-8651 |
| Popis: | This prospective, randomized, clinical trial compared pain intensity and analgesic drug consumption after anterior cruciate ligament (ACL) reconstruction with patellar tendon under femoral-sciatic nerve block anesthesia in patients who received either a continuous femoral nerve block (CFNB) or continuous local anesthetic wound and intra-articular infusions.Fifty patients were randomized to CFNB (n = 25) or an ON-Q device (I-Flow Corp, Lake Forest, Calif) (n = 25). All patients received sciatic nerve block (25 mL of ropivacaine 7.5 mg/mL and clonidine 30 microg). The first group received a CFNB (2 mg/mL of ropivacaine at 7 mL/hr), and the second group received a single-shot femoral nerve block (both using 25 mL of ropivacaine 7.5 mg/mL and clonidine 30 microg). At the end of the intervention, an ON-Q device was positioned on the ON-Q patients to continuously infuse the patellar tendon wound and intra-articular cavity with ropivacaine 2 mg/mL at 2 mL/hr for each catheter. Data regarding demographic, hemodynamic, pain scores, adverse effects, and need for supplemental analgesia were registered in a 36-hr follow-up period.The CFNB group reported lower visual analog scale values than the ON-Q group: at rest at 12 hrs (2.4 [SD, 2.2] vs 5.4 [SD, 3.1]; P0.001) and on movement at 12 (3.1 [SD, 2.5] vs 6.3 [SD, 2.9]; P0.001) and 24 hrs (2.7 [SD, 1.9] vs 4.6 [SD, 2.6]; P = 0.01) after surgery. The number of morphine and ketorolac boluses was lower in the CNFB group (morphine: 3.2 [SD, 2.2] vs 6.2 [SD, 2.5]; P0.001; ketorolac: 1.1 [SD, 1.0] vs 2.4 [SD, 0.9]; P0.001).Continuous femoral nerve block provides better analgesia than the continuous patellar tendon wound and intra-articular infusions after anterior cruciate ligament reconstruction with patellar tendon. |
| Databáze: | OpenAIRE |
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