title: Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty.
abstract: This study was designed to determine the effects of continuous femoral infusion (CFI) on total knee arthroplasty recovery. A total of 92 patients were distributed in 3 groups: Patients in group 1 received general anesthesia followed by patient-controlled analgesia (PCA) with morphine (n = 33), patients in group 2 received 3-in-1 and sciatic blocks followed by CFI (n = 29), and patients in group 3 received epidural analgesia (n = 30). Blocks reduced postoperative morphine requirement by 74% (vs group 1; P<.05) and 35% (vs group 3; P<.05). Blocks provided better recovery than PCA with morphine or an epidural. The use of CFI was associated with a reduction of postoperative bleeding by 72% (vs group 1; P<.05) and allowed better performance on continuous passive motion. CFI was associated with a 90% decrease in serious complications and a 20% decrease in the length of hospitalization. CFI represents a better alternative than PCA or epidural analgesia for postoperative pain management and immediate rehabilitation after total knee arthroplasty.
authors.affiliation: Department of Anesthesiology, University of Texas Medical School at Houston, Houston, Texas 77030-1503, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Chelly
authors.forename: J
authors.initials: J
authors.lastname: Greger
authors.forename: R
authors.initials: R
authors.lastname: Gebhard
authors.forename: K
authors.initials: K
authors.lastname: Coupe
authors.forename: T A
authors.initials: TA
authors.lastname: Clyburn
authors.forename: R
authors.initials: R
authors.lastname: Buckle
authors.forename: A
authors.initials: A
authors.lastname: Criswell
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local