Continuous Adductor Canal Versus Continuous Femoral Nerve Blocks: Relative Effects on Discharge Readiness Following Unicompartment Knee Arthroplasty
| Autor: | Daniel I. Sessler, Francis B. Gonzales, Bahareh Khatibi, Amanda M. Monahan, Sarah J. Madison, Nicholas J. Kormylo, Anthony T. Machi, Jing You, Jacklynn F. Sztain, Wendy B. Abramson, Scott T. Ball, Brian M. Ilfeld, Ken A. Nakanote, Edward J. Mascha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Adductor canal medicine.medical_treatment Replacement Clinical Sciences Pain Pilot Projects and over Discharge readiness Arthroplasty Femoral nerve Anesthesiology Interquartile range 80 and over medicine Humans Knee Prospective Studies Postoperative Prospective cohort study Arthroplasty Replacement Knee Aged Pain Measurement Aged 80 and over Pain Postoperative Ropivacaine business.industry General Medicine Middle Aged Patient Discharge Surgery Catheter Anesthesiology and Pain Medicine medicine.anatomical_structure Treatment Outcome Anesthesia Female business Femoral Nerve medicine.drug Autonomic Nerve Block |
| Zdroj: | Sztain, JF; MacHi, AT; Kormylo, NJ; Abramson, WB; Madison, SJ; Monahan, AM; et al.(2015). Continuous Adductor Canal Versus Continuous Femoral Nerve Blocks: Relative Effects on Discharge Readiness Following Unicompartment Knee Arthroplasty. Regional Anesthesia and Pain Medicine, 40(5), 559-567. doi: 10.1097/AAP.0000000000000279. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/5b53n8cd Regional anesthesia and pain medicine, vol 40, iss 5 |
| DOI: | 10.1097/AAP.0000000000000279. |
| Popis: | © 2015 American Society of Regional Anesthesia and Pain Medicine. Background We tested the hypothesis that, following unicompartment knee arthroplasty, a continuous adductor canal block decreases the time to reach 4 discharge criteria compared with a continuous femoral nerve block. Methods Subjects were randomized to either an adductor canal or femoral perineural catheter (2-day ropivacaine 0.2% infusion) in an unmasked fashion. The primary outcome was the time to attain 4 discharge criteria: (1) adequate analgesia; (2) intravenous opioid independence; (3) ability to independently stand, walk 3 m, return, and sit down; and (4) ambulate 30 m. Results Subjects with an adductor canal catheter (n = 15) reached all 4 criteria in a median of 35 hours (interquartile range, 24-43 hours), compared with 40 hours (interquartile range, 27-69 hours) for those with a femoral catheter (n = 15; Wilcoxon rank sum test: P = 0.46; log-rank test: P = 0.16). However, the percentages of subjects (adductor canal: femoral) who reached the 2 mobilization criteria were 27%:0% on postoperative day (POD) 0, 93%:53% on POD 1, and 100%:73% on POD 2. Of adductor canal subjects, 100% were discharge ready by POD 2, compared with only 73% of femoral subjects (P < 0.001). Conclusions Compared with a continuous femoral nerve block, a continuous adductor canal block did not appreciably decrease the median number of hours to overall discharge readiness, yet did decrease the number of discrete days until discharge readiness. These results are applicable to only unicompartment knee arthroplasty and must be considered preliminary because of the limited sample size of this pilot study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|