Postoperative Analgesie nach Knie-TEP

Kutzner, K.P.; Paulini, C.; Hechtner, Marlene; Rehbein, Philipp; Pfeil, Joachim

doi:10.1007/s00132-015-3115-y

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…It might be favorably to use a higher dose of LIA to have an immediate effect after surgery. However, compared to other studies the pain relief of the intraarticular analgesia was similar to pain NRS grade 4 on the day of surgery and postoperative day 1 [9,14]. Beyond 24 h, continuous PNB's did not result in superior pain relief.…”

Section: Discussionsupporting

confidence: 48%

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Slightly better pain relief but more frequently motor blockade with combined nerve block analgesia compared to continuous intraarticular analgesia after total knee arthroplasty

Lützner

Gehring

Beyer

2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Pain management after total knee arthroplasty (TKA) is still under debate. Continuous peripheral nerve blocks (PNB) can provide long pain relief but impair muscle function. Continuous intraarticular analgesia could result in longer pain relief than local infiltration analgesia without negative effects on muscle function. This study investigated the efficacy of pain control between PNB's and continuous intraarticular analgesia after TKA. Methods A prospective randomized study on 140 patients undergoing TKA was performed. Patients received either a combination of continuous femoral nerve block, continuous sciatic nerve block and single-shot obturator nerve block (group R) or a local infiltration analgesia and a continuous intraarticular catheter with ropivacaine (group L). Primary outcome was pain measured on a numerical rating scale. Knee function, patient-reported outcome (PRO) and adverse events were assessed until 1 year after surgery. Results Pain at rest was lower in group R on the day of surgery (mean NRS 3.0 vs. 4.2) and the morning of postoperative day 1 (mean NRS 3.4 vs. 4.4). Motor blockade longer than postoperative day 3 occurred more often in group R compared to group L (15.3% vs. 1.5%). Pain levels, PRO and satisfaction 3-month and 1-year after surgery were similar. Conclusion Continuous PNB's were slightly more effective in the first 24 h after surgery but were associated more often with motor blockade which should be avoided. It must be balanced if the small amount of better pain relief immediately after surgery justifies the risks associated with motor blockade following PNB's. Level of evidence I.

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Section: Discussionsupporting

confidence: 48%

“…Previous studies provided no conclusive results for the use of continuous intraarticular analgesia with infusion pumps. While some studies demonstrated the efficacy of continuous intraarticular analgesia [4, 5, 13] other studies did not find a relevant effect [2, 9, 14, 22, 24].…”

Section: Introductionmentioning

confidence: 99%

Slightly better pain relief but more frequently motor blockade with combined nerve block analgesia compared to continuous intraarticular analgesia after total knee arthroplasty

Lützner

Gehring

Beyer

2020

Knee Surg Sports Traumatol Arthrosc

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“…An important point to consider is the different types and concentrations of local anaesthetics used in the studies. The same applies to LIA, where the variety of substances used, their concentrations, volume, and site of application vary widely [ 14 – 19 ]. Another important point is the type of anaesthesia, where in some studies spinal, general, or both were used [ 15 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Femoral nerve blockade versus local infiltration analgesia for primary knee arthroplasty. Randomised controlled trial

Moreno¹,

Tsamassiottis²,

Ettinger³

et al. 2022

ait

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Pain following total knee arthroplasty (TKA) and the methods of approaching it has been a topic of interest for many years. Options for pain management range from administration of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, epidural analgesia, and patient-controlled analgesic modalities to numerous peripheral nerve blocks with or without indwelling catheters [1-3]. Among these, a well-established method is blockade of the femoral nerve (FNB) using long-acting local anaesthetics, which are frequently combined with an indwelling catheter to provide an even more prolonged anaesthetic effect. In parallel, in recent years, the intra-and periarticular administration of local anaesthetics, combined with a variety of other substances such as opioids, NSAIDS, magnesium, and adrenaline

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Interdisziplinäres Positionspapier „Perioperatives Schmerzmanagement“

Likar

Jaksch

Aigmüller

et al. 2017

Schmerz

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Despite many positive developments, postoperative pain and its treatment is still not always given the necessary attention. Severe pain after surgical procedures affects a significant proportion of patients. This very fact is not only detrimental to the immediate recovery process, but can also form the basis for the development of chronic pain conditions.An adequate and effective management of perioperative pain requires appropriate organizational structures. This multidisciplinary paper which was initiated by the Austrian Society for Anaesthesiology and Intensive Care and the Austrian Pain Society and developed together with numerous specialist and professional societies dealing with the subject aims at supporting the organization of perioperative pain management structures and to make best use of proven concepts. Additional recommendations describe specific interventions for selected types of intervention.

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Postoperative Analgesie nach Knie-TEP

Abstract: 8,6 ± 2,2 8,0 (7,0-10,0) a 9,0 ± 2,2 8,0 (7,0-10,0) a 8,8 ± 2,2 8,0 (7,0-10,0) a IAK intraartikuläres Kathetersystem, MW Mittelwert, NFK Nervus-femoralis-Katheter, SD Standardabweichung a Median (Interquartilsabstand)

Cited by 7 publications

References 24 publications

Slightly better pain relief but more frequently motor blockade with combined nerve block analgesia compared to continuous intraarticular analgesia after total knee arthroplasty

Slightly better pain relief but more frequently motor blockade with combined nerve block analgesia compared to continuous intraarticular analgesia after total knee arthroplasty

Femoral nerve blockade versus local infiltration analgesia for primary knee arthroplasty. Randomised controlled trial

Interdisziplinäres Positionspapier „Perioperatives Schmerzmanagement“

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