Femoral nerve block and ketorolac in patients undergoing anterior cruciate ligament reconstruction.
OBJECTIVE
The primary objective was to evaluate the analgesic effectiveness of femoral nerve block and ketorolac following ACL reconstruction. The secondary objective was to examine their effects on recovery milestones.


METHODS
Prior to standard general anesthesia, 90 patients were randomized into three groups of preoperative treatment: 1) femoral nerve block (15 mL bupivacaine 0.5%) and 1 mL normal saline i.v. (FNB group); 2) placebo femoral nerve block (15 mL normal saline) and 30 mg (1 mL) ketorolac i.v. (KT group); 3) placebo femoral nerve block (15 mL normal saline) and 1 mL normal saline i.v. (PL group). Postoperatively, pain was assessed by visual analogue score, demand and consumption of morphine via patient-controlled analgesia pump. The times for patients to tolerate oral fluid, food, sit up, ambulate and void were also noted.


RESULTS
Morphine consumption within one hour, three hours and until POD 1 in the FNB group was lower than the PL group (7 +/- 6, 11 +/- 9, 27 +/- 23 mg vs 13 +/- 5, 20 +/- 9, 49 +/- 28 mg respectively), whereas only that within one hour in the KT group was lower than the PL group. Pain score was lower in FNB and KT groups in the first postoperative hour than in the PL group (P < 0.05). There were no differences among the three groups in the times to meet recovery milestone and discharge criteria.


CONCLUSIONS
Femoral nerve block provides superior analgesia than placebo for ACL reconstruction but was insufficient to facilitate early recovery.
Peng
P
P
Department of Anesthesia, Toronto Hospital, University of Toronto, Ontario, Canada. ppeng@torhosp.toronto.on.ca
Claxton
A
A
Chung
F
F
Chan
V
V
Miniaci
A
A
Krishnathas
A
A
D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001340:Autonomic Nerve Block; D004311:Double-Blind Method; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control; D019651:Plastic Surgery Procedures
D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac