Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: a prospective randomized study

Nishio, Shoji; Fukunishi, Shigeo; Miura, Junro; Koyanagi, Sahoko; Fujihara, Yuki; Fukui, Tomokazu; Yoshiya, Shinichi

doi:10.4081/or.2014.5138

Cited by 16 publications

(12 citation statements)

References 29 publications

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“…Various modes of peripheral nerve blockade have been proposed and examined in previous literatures. 1 - 3 , 10 , 11 , 17 - 20 , 22 - 25 The effectiveness and safety have been examined for each of those techniques. 2 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

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Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

et al. 2017

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In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

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Section: Discussionmentioning

confidence: 99%

“… 3 , 16-20 We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after THA procedure. 17 In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA.…”

Section: Introductionmentioning

confidence: 99%

Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

et al. 2017

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“…The Student's t-test for continuous variables and the chisquare or Fisher's exact test for categorical variables were used to compare the baseline of the two groups. The ICDSC scores (0, 12, 24, and 36 hours after extubation), as well as the NRS scores (0, 8, 16, and 24 hours after extubation) across time points, were compared between the two groups using a repeated-measures analysis of variance. p-Values <0.05 were considered statistically significant.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Pisani et al [15] reported that continuous administration of an opioid was associated with persistent delirium in older intensive care unit (ICU) patients. Nishino et al [16] similarly found that the use of opioids should not be advocated because of the risk of analgesia-related complications, although continuous administration of opioids allows for more prolonged post-surgical analgesic effects.…”

Section: Introductionmentioning

confidence: 99%

A single-center retrospective observational cohort study on postoperative pain management: better with single or continuous doses of opiates or acetaminophen?

Tennichi

Taniguchi

2019

Preprint

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Background: Proper pain management after cardiac surgery is essential for the prevention of postoperative complications, and several protocols have been proposed in this regard. The continuous administration of an opioid is a common approach now because it allows for more prolonged post-surgical analgesic effects. However, this method has several problems, such as the incidence of protracted delirium, nausea, and vomiting. The present study aims to evaluate the effects of two opioid administration methods on postoperative pain management and other clinical outcomes after cardiac surgery. Methods: This is a retrospective observational cohort study that enrolled 184 adult patients who underwent elective cardiac surgery. After ICU admission, patients were divided into two groups: 101 patients who received a single administration of fentanyl (25 mg boluses and a 30 min lockout time) and an administration of acetaminophen (l5 mg kg-1 and a 6 hour lockout time) [group S] and 83 patients who underwent continuous administration of fentanyl (25 mg hour-1 with 35 mg boluses and a 30 min lockout time) and an administration of acetaminophen (l5 mg kg-1 and a 6 hour lockout time) [group C]. For all patients, the Intensive Care Delirium Screening Checklist (ICDSC) scores were measured soon after extubation (0 hours) and 12, 24, and 36 hours later. Similarly, for all patients, NRS scores were also quickly measured after extubation (0 hours) and 8, 16, and 24 hours later. Results: ICDSC scores in group S were significantly lower than those in group C 0 and 12 hours after extubation (p < 0.001). However, ICDSC scores 24 and 36 hours post extubation did not differ significantly between the two groups. NRS scores did not differ significantly between the two groups until 24 hours after extubation. Conclusions: Compared with single administration of fentanyl with acute administration of acetaminophen, continuous administration of postoperative fentanyl with acute administration of acetaminophen may lead to increased risk for postoperative delirium. Therefore, acute administration of fentanyl may be preferable for continuous use in postoperative cardiac surgery patients.

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“…However, there are little data on efficacy and adverse effects of pain therapy after converting an established protocol (EA) to a modified protocol (FNB) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Epidural analgesia compared with femoral nerve block for postoperative pain therapy after total knee arthroplasty – a matched pair analysis

Kozian¹

2017

SDRP-JAS

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Background:Combined epidural analgesia (EA) and patient controlled analgesia (PCA) for postoperative pain control after total knee arthroplasty (TKA) is well established. Previous studies demonstrated the effectiveness of femoral nerve block (FNB) in combination with PCA. This study compares clinical efficiency and adverse events of pain therapy of an established (EA+PCA) and a modified (FNB+PCA) protocol. Methods:A retrospective, single-center cohort study analyzing TKA patients after subarachnoid anesthesia. Matched pair analysis was performed using filters for American Society of Anesthesiologists (ASA) classification, age, gender, height, weight, comorbidities and prior use of analgesics. Surgical technique and postoperative medication protocol were similar in both groups. Primary outcome was postoperative pain on movement assessed by a visual analog scale (VAS) and use of analgesics within 72 hours after surgery. Secondary, incidence of adverse events (postoperative nausea and vomiting, pruritus, urinary retention and hypotension) was examined.Results: From a total of 846 patients, 104 matched pairs were built and analyzed within 72 hours after surgery. Mean VAS scores were similar in patients receiving EA+PCA (2.7 ± 1.1) or FNB+PCA (2.8 ± 1.2). Supplemental opioid administration was higher in EA+PCA patients. Hypotension was more frequent in EA+PCA as in FNB+PCA patients (36 % vs. 12 %). Combined adverse events were more frequent in EA+PCA as in FNB+PCA patients (75 % vs. 58 %). Conclusion: Both FNB+PCA and EA+PCA results in equivalent degrees of analgesia after TKA. Converting an established mode of pain therapy to a modified protocol may decrease incidence of adverse events rather than improve quality of analgesia. EPIDURAL ANALGESIA COMPARED WITH FEMORAL NERVE BLOCK FOR POSTOPERATIVE PAIN THERAPY AFTER TOTAL KNEE ARTHROPLASTY -A MATCHED PAIR ANALYSIS

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Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: a prospective randomized study

Cited by 16 publications

References 29 publications

Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

A single-center retrospective observational cohort study on postoperative pain management: better with single or continuous doses of opiates or acetaminophen?

Epidural analgesia compared with femoral nerve block for postoperative pain therapy after total knee arthroplasty – a matched pair analysis

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