Safety and Efficacy of Continuous Femoral Nerve Catheter with Single Shot Sciatic Nerve Block vs Epidural Catheter Anesthesia for Same-Day Bilateral Total Knee Arthroplasty

Patel, Navin B.; Solovyova, Olga; Matthews, Gregory J.; Arumugam, Sivasenthil; Sinha, Sanjay; Lewis, Courtland G.

doi:10.1016/j.arth.2014.09.015

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…Although good pain relief may be achieved by continuous epidural anesthesia or femoral nerve block (FNB), each of the two methods has adverse effects such as muscle weakness, which may delay post-operative mobilization (2,3). Peripheral nerve blockade may provide adequate analgesia with preserved muscle function, and is therefore considered more desirable.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of perineural dexamethasone with ropivacaine in adductor canal block for post-operative analgesia in patients undergoing total knee arthroplasty: A randomized controlled trial

Wang

Long

Yang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Adductor canal block (ACB) is an effective analgesic alternative to femoral nerve block after total knee arthroplasty (TKA). The aim of the present study was to investigate whether addition of dexamethasone to ropivacaine for ACB is able to prolong analgesia and reduce pain. Study participants were randomized into groups receiving ACB with either 0.5% ropivacaine + normal saline (control group; n=93) or 0.5% ropivacaine + 8 mg dexamethasone (dexamethasone group; n=93). All patients were subjected to identical peri-operative management. Patients were assessed for the duration of analgesia by the return of pinprick sensation. A numerical rating scale, ranging from 0 to 10, was used to assess post-operative pain at 6, 12, 18, 24 and 48 h. Opioid use was recorded. Serum C-reactive protein and interleukin-6 levels were measured at 3, 6, 12, 24 and 48 h after surgery. The results revealed that the duration of sensory block was significantly longer in the dexamethasone group (23.42±3.35 vs. 14.67±2.96 h in control group, P<0.05). The dexamethasone group also had significantly lower pain scores at 6, 12, 18 and 24 h after surgery (all P<0.001), and at 48 h, pain was comparable in the two groups. Reduction in post-operative pain was associated with a decrease in serum C-reactive protein.Morphine use in the first 24 h after surgery was also lower in the dexamethasone group (4.23±1.80 vs. 8.42±2.44 mg in control group, P<0.05). In conclusion, addition of dexamethasone to ropivacaine for ACB was able to prolong the duration of analgesia and decreased early post-operative pain following TKA.

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Section: Introductionmentioning

confidence: 99%

Efficacy of perineural dexamethasone with ropivacaine in adductor canal block for post-operative analgesia in patients undergoing total knee arthroplasty: A randomized controlled trial

Wang

Long

Yang

et al. 2017

Experimental and Therapeutic Medicine

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“…1 Although the potential for local infiltration analgesia (LIA) 2 and adductor canal block 3 techniques await to be fully elucidated, 4 in many centres femoral nerve block (FNB) remains a mainstay of multi-modal analgesic management following TKA. [5][6][7][8][9] Despite a functioning FNB, however, TKA continues to be associated with moderate-to-severe postoperative pain in the majority of patients. 10 To improve pain control, it has been suggested that proximal sciatic nerve block (SNB) performed between the parascacral and mid-thigh regions should be added to FNB in patients undergoing TKA.…”

mentioning

confidence: 99%

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Abdallah

Madjdpour

Brull

2016

Can J Anesth/J Can Anesth

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“…Lee et al (15) found that PCIA provided less better analgesia and more side effects such as nausea and sedation compared with continuous peripheral block. Patel et al (16) found peripheral nerve block was safe with a significant decrease in postoperative complications and provided adequate pain relief compared to epidural anesthesia CFNB and PCIA are two commonly used methods for postoperative analgesia after TKA. Our study showed that CFNB could achieve satisfactory clinical outcomes during hospitalization (PCIA: N=123, CFNB: N=127) and at 6 months postoperatively (PCIA: N=102, CFNB: N=109) on the basis of relatively low total cost, in which part of analogous data was also observed in many other researches (17)(18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…* A significant difference between group CFNB and PCIA, P<0.05. CFNB for continuous femoral nerve block, and PCIA for patient-controlled intravenous an-were 18(16)(17)(18)(19)(20)(21)(22) and21(17)(18)(19)(20)(21)(22)(23)(24) at 6 months post-operatively; the change of WOMAC score (defined as minus in thefigure 2…”

mentioning

confidence: 99%

Continuous Femoral Nerve Block versus Patient-Controlled Intravenous Analgesia for Patients Undergoing Unilateral Total Knee Arthroplasty: A Cost-Effectiveness Analysis and Cost-Utility Analysis

Qin¹,

Min²,

Peng³

et al. 2016

J Anesth Perioper Med

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Continuous femoral nerve block versus patient-controlled intravenous analgesia for patients undergoing unilateral total knee arthroplasty: a cost-effectiveness analysis and cost-utility analysis. J Anesth Perioper Med 2016; 3: 160-170.Background: In order to relieve pain following total knee arthroplasty (TKA), patient-controlled intravenous analgesia (PCIA) and continuous femoral nerve block (CFNB) are commonly used for postoperative analgesia. Nowadays, anesthesiologists are more and more interested in reducing patients'financial burden while providing effective analgesia. Therefore, this study investigated the cost-effectiveness and costutility of CFNB versus PCIA for patients undergoing unilateral TKA. Methods: Patients were randomly divided into CFNB group and PCIA group. Ultrasound-guided femoral nerve block was performed for CFNB group, and PCIA was used in the other group. The effects of analgesia during hospital stay, pain intensity and knee function at 6 months after discharge were evaluated. The cost of analgesia, direct medical cost, indirect cost, total cost, cost-effectiveness ratio, cost-utility ratio, and incremental cost-effectiveness ratio were calculated.

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Safety and Efficacy of Continuous Femoral Nerve Catheter with Single Shot Sciatic Nerve Block vs Epidural Catheter Anesthesia for Same-Day Bilateral Total Knee Arthroplasty

Cited by 15 publications

References 18 publications

Efficacy of perineural dexamethasone with ropivacaine in adductor canal block for post-operative analgesia in patients undergoing total knee arthroplasty: A randomized controlled trial

Efficacy of perineural dexamethasone with ropivacaine in adductor canal block for post-operative analgesia in patients undergoing total knee arthroplasty: A randomized controlled trial

Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis

Continuous Femoral Nerve Block versus Patient-Controlled Intravenous Analgesia for Patients Undergoing Unilateral Total Knee Arthroplasty: A Cost-Effectiveness Analysis and Cost-Utility Analysis

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