Clinical effects of single femoral nerve block in combination with general anesthesia on geriatric patients receiving total knee arthroplasty

Abstract

Objective:To evaluate the clinical effects of single femoral nerve block (sFNB) combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty (UTKA).Methods:Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway (FLA) group, an sFNB + tracheal intubation (FGA) group and a tracheal intubation (GA) group. Their clinical parameters and indices were recorded. They were scored by the Visual Analogue Scale (VAS).Results:All patients completed this study. FLA and FGA groups used less propofol, remifentanil and fentanyl than GA group (P<0.01), with shorter recovery time and extubation time (P<0.05). Compared to GA group, FLA and FGA groups had lower systolic blood pressures at T3, T4 and T5 (P<0.05), and lower heart rates at T5 (P<0.05). FLA and FGA groups had fewer cases of adverse reactions after extubation (P<0.01). FLA group was less prone to irritating cough after extubation and pharyngeal pain than FGA and GA groups (P<0.01). The postoperative six hour and 24 hour VAS scores in resting state as well as the postoperative 24 hour and 48 hour scores in training state of FLA and FGA groups were lower than those of GA group (P<0.05). FLA and FGA groups used significantly lower times and total doses of patient-controlled intravenous analgesia pump.Conclusion:sFNB combined with general anesthesia, especially that using laryngeal mask, were superior to general anesthesia alone, which reduced recovery and extubation times, and decreased intraoperative and postoperative drug uses, postoperative early VAS score and adverse reactions.

Multimodal neural block analgesia versus morphine analgesia after elective knee surgery

“…Reduction in the pain intensity, judged according to the lower scores on the NPS in comparison with the opioid group, found in the FNB group was in accordance with the results of several other clinical trials. [29][30][31][32][33][34][35][36] Publications on the postoperative efficacy of FICNB are less abundant, but a meta-analysis unequivocally confirms the results of the present study. 37 One of the rare available clinical studies publishing the head-tohead comparison between 3-in-1 FNB and FIC-NB found no difference in the efficacy and safety of these two multi-modal analgesic techniques, 34 corroborating thus the current results.…”

[Retracted] Impacts of Ultrasound‐Guided Nerve Block Combined with General Anesthesia with Laryngeal Mask on the Patients with Lower Extremity Fractures

“…A certain dose of additional intravenous sedatives or general anesthesia is required to obtain the best anesthetic effect, resulting in guarantee of adequate oxygen supply during surgery. A study of total knee arthroplasty demonstrated that femoral nerve block combined with general anesthesia alleviated postoperative pain and exhibited declined 6 h and 24 h VAS scores in resting state after surgery [ 31 ]. In the present study, comparing to general anesthesia group, the combined anesthesia group had much lower VAS score at 6 h, 12 h, and 24 h after surgery.…”

Peripheral regional anaesthesia and outcomes: a narrative review of the literature from 2013 to 2023

“… 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 More recently, there has been an increase in the emphasis of scientific investigations involving hip surgery, whereas only three studies were published from 2003 to 2013. In the current period, femoral nerve block is described for hip surgery (total hip arthroplasty or hip arthroscopy), 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 femoral fracture, 48 , 49 , 50 knee surgery (total knee arthroplasty, anterior cruciate ligament reconstruction), 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 51 , 52 , 53 , 54 , 55 , 56 , 57 and tibial fracture/osteotomy. 58 , 59 Endovenous laser ablation is also described as an indication for femoral nerve block.…”

“…The majority of femoral nerve blocks used ultrasound guidance (22 studies), 23 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 39 , 42 , 47 , 48 , 49 , 54 , 56 , 57 , 59 , 60 , 61 but 10 studies used nerve stimulation, 22 , 27 , 34 , 40 , 41 , 44 , 45 , 46 , 50 , 52 and eight studies did not report the nerve identification technique or were not clear in their description. 24 , 25 , 38 , 43 , 51 , 53 , 55 , 58 …”