Negative Influence of femoral nerve block on quadriceps strength recovery following total knee replacement: A prospective randomized trial

Amata, Michele; Belzile, Étienne L.; Vachon, Jessica; Beauchamp-Chalifour, Philippe; Pelet, Stéphane

doi:10.1016/j.otsr.2019.03.002

Cited by 24 publications

(21 citation statements)

References 17 publications

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“…Another important aim of a pain management modality is to facilitate rehabilitation and functional recovery. A variety of outcome parameters have been evaluated and compared between cFNB and sFNB with mixed results [12,14,[17][18][19]. Chan et al compared the time required to achieve several functional performance goals including range of motion to 90°, active straight leg raise, the need for ambulating assistance with walking aids and obstacle clearance between cFNB and sFNB [12].…”

Section: Discussionmentioning

confidence: 99%

“…Patients that received PCA alone performed better on these outcome domains compared with patients who received either cFNB or sFNB plus PCA. Interestingly, the effect of decreased quadriceps strength recovery in the cFNB and sFNB group could last up to 12 months [14]. We can only describe the functional outcomes qualitatively rather than to perform a quantitative analysis because of the heterogenous outcome domains used in the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Although cFNB was associated with less opioid consumption compared with the sFNB group, this benefit did not seem to translate to a faster functional recovery or a shorter length of hospital stay. In addition, the 5 studies that evaluated duration of hospital stay had different discharge criteria [10,12,14,18,19]. The heterogenous discharge criteria could greatly weaken the clinical implication of this parameter.…”

Section: Discussionmentioning

confidence: 99%

“…FNB has been proven to have a beneficial effect on pain management but it remains uncertain whether cFNB can lead to additional benefits compared with that of sFNB in the setting of multimodal analgesic protocols (eg. pain scores at different time points, amount of opioid consumption, adverse effects of opioids, length of hospital stay and functional outcomes) [9][10][11][12][13][14]. Due to the mixed results in current literature, it is undetermined whether the additional benefits of cFNB over sFNB are worthy of its extra cost and time involved.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis

Hsiao

Chou

Tsai

et al. 2020

BMC Musculoskelet Disord

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Background: Continuous femoral nerve block (cFNB) has been developed to extend the analgesic effect since the efficacy of single-injection femoral nerve block (sFNB) is often limited to approximately 16-24 h. The aim of this meta-analysis was to validate the add-on effect of cFNB in the setting of a multimodal analgesic protocol. Methods: We performed a comprehensive literature review on Web of Science, Embase, the Cochrane Library and PubMed. Eight randomized controlled trials (N = 626) that compared the efficacy of cFNB with sFNB were included. The primary outcome domains consist of visual analog scale (VAS) score at postoperative 24 and 48 h. The secondary outcome domains include opioid consumption, length of hospital stay and incidence of nausea. Results: Our analysis revealed that cFNB was associated with a lower VAS score at 24 h (SMD:-0.277;95% CI − 0.503 to − 0.05). However, the difference of VAS score did not meet the minimal clinically importance difference for total knee arthroplasty (TKA). VAS score at 48 h was similar between the cFNB and sFNB group. The cFNB group was associated with less amount of opioids consumed at both 24(SMD:-1.056;95% CI − 1.737 to − 0.375) and 48 h(SMD:-1.040;95% CI − 1.790 to − 0.289). Length of hospital stay and incidence of nausea were similar between the two groups. Conclusion: In the setting of a multimodal analgesic protocol, patients might benefit from cFNB with regards to a reduced need of opioids in the early postoperative period. However, we did not find a clinically significant difference in pain scores at different time points between the cFNB and sFNB group. Level of evidence: I; meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis

Hsiao

Chou

Tsai

et al. 2020

BMC Musculoskelet Disord

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“…Several methods (femoral nerve block [7], intrathecal morphine (ITM) [8], local infiltration analgesia [9], nonsteroidal anti-inflammatory drugs, oral opiates, and gabapentinoids [10]) have been applied in clinical practice for pain control in hip and knee surgeries. Femoral nerve blocks may increase the occurrence of falls and thus have limited clinical use [11]. Oral opiates and gabapentinoids may be associated with complications such as nausea, vomiting, and somnolence [12].…”

Section: Introductionmentioning

confidence: 99%

Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty

Cai¹,

Liu²,

Wu³

et al. 2020

J Orthop Surg Res

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Background: The purpose of this meta-analysis was to assess the efficacy of intrathecal morphine (ITM) analgesia and local infiltration analgesia (LIA) for pain control in total joint arthroplasty (TJA). Methods: Embase, PubMed, the Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCTs). All RCTs were comparing intrathecal analgesia and local infiltration analgesia in TJA. Primary outcomes were the visual analog scale (VAS) score with rest or mobilization up to 72 h. Secondary outcomes were the total morphine consumption, length of hospital stay, and morphine-related complications. Results: Compared with the intrathecal analgesia group, the LIA group was associated with a reduction in VAS score with rest up to 72 h. Moreover, LIA was associated with a decrease in VAS score with mobilization at 6 h, 12 h, 48 h, and 72 h. Moreover, LIA significantly reduced total morphine consumption (weighted mean difference (WMD) = − 15.37, 95% CI − 22.64 to − 8.83, P = 0.000), length of hospital stay (WMD = − 1.39, 95% CI − 1.67 to − 1.11, P = 0.000), and morphine-related complications (nausea and pruritus). Conclusions: Local infiltration provided superior analgesia and morphine-sparing effects within the first 72 h compared with ITM following TJA.

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Advancing pain management for extremity trauma: the evolution of ultrasound-guided nerve blocks for patients in the supine position in trauma centers

Huaguo,

Kang,

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Trauma, particularly extremity trauma, poses a considerable challenge in healthcare, especially among young adults. Given the severity of patient pain and the risks associated with excessive opioid use, managing acute pain in trauma centers is inherently complex. This study aims to investigate the application and benefits of ultrasound-guided nerve blocks for early pain management in patients with extremity trauma positioned supine. Methods A comprehensive literature review was conducted to assess the effectiveness and advantages of ultrasound-guided peripheral nerve blocks in the acute pain management of extremity trauma patients in the supine position. Special emphasis was placed on evaluating the selection criteria, indications, contraindications, adverse reactions, and potential complications associated with these nerve block techniques. Results Ultrasound-guided nerve blocks represent a safer and more precise option for managing pain in extremity trauma patients placed in the supine position. These techniques offer significant advantages in terms of reducing healthcare expenses, diminishing reliance on opioid medications, and mitigating opioid-related complications. Nonetheless, challenges may arise due to the necessity for patient cooperation during specific nerve block procedures. Conclusion Ultrasound-guided nerve blocks present a promising avenue for early pain management in extremity trauma patients positioned supinely. Their implementation can lead to improved patient outcomes by alleviating pain severity, reducing opioid consumption, and cutting down healthcare costs. Further research and clinical integration of these techniques is imperative to enhance pain management protocols in trauma centers.

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Negative Influence of femoral nerve block on quadriceps strength recovery following total knee replacement: A prospective randomized trial

Cited by 24 publications

References 17 publications

The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis

The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis

Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty

Advancing pain management for extremity trauma: the evolution of ultrasound-guided nerve blocks for patients in the supine position in trauma centers

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