Ultrasound-guided adductor canal block combined with lateral femoral cutaneous nerve block for post-operative analgesia following total knee arthroplasty: a prospective, double-blind, randomized controlled study
| Autor: | Mohammed Alqwbani, Zhouyuan Yang, Pengde Kang, Qiuru Wang, Donghai Li, Ren Liao |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Adductor canal law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Prospective Studies Anesthetics Local Arthroplasty Replacement Knee Adverse effect Ultrasonography Interventional 030203 arthritis & rheumatology Pain Postoperative 030222 orthopedics business.industry Nerve Block musculoskeletal system Analgesics Opioid medicine.anatomical_structure Lateral femoral cutaneous nerve block Anesthesia Orthopedic surgery Infiltration analgesia Surgery Analgesia Complication Range of motion business Femoral Nerve |
| Zdroj: | International Orthopaedics. 45:1421-1429 |
| ISSN: | 1432-5195 0341-2695 |
| DOI: | 10.1007/s00264-020-04549-2 |
| Popis: | The purpose of this study was to investigate whether adductor canal block (ACB) combined with lateral femoral cutaneous nerve block (LFCNB) could improve the efficacy of post-operative analgesia in a comparison with a standard peri-articular infiltration analgesia (PIA) after a total knee arthroplasty (TKA).One hundred and sixty patients of scheduled unilateral primary TKA were randomly allocated into two groups for post-operative analgesia. Eighty cases were treated with ACB combined with LFCNB and the other eighty treated with PIA. The primary outcomes were pain visual analogue scale (VAS) and rescue pain killer consumption, and the secondary outcomes were knee active range of motion (ROM), quadriceps strength, patients' ambulation ability, Knee Society Score (KSS), length of hospital stay, and adverse events.We found that ACB combined with LFCNB was better on decreasing the post-operative pain score within 12 hours at rest and 8 h with activity (p 0.05) and provided longer duration of analgesia (19.91 ± 5.09 VS 12.06 ± 3.67 h, p 0.01) and less rescue morphine consumption (13.63 ± 9.84 vs 18.00 ± 11.52 mg, p = 0.011) than the PIA. There was no significant difference between the two groups (p 0.05) in terms of knee ROM, quadriceps strength, daily mobilization distance, KSS, and complication occurrence.ACB combined with LFCNB provides a significantly better pain control, less opioid consumption, and longer duration of analgesia than peri-articular infiltration while preserving muscle function without affecting knee functional recovery nor the length of stay or side effects occurrence. |
| Databáze: | OpenAIRE |
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