title: Femoral nerve block for total knee arthroplasty patients: a method to control postoperative pain.
abstract: This study was designed to determine the effects of a single-injection femoral nerve block (FNB) using 30 mL of 0.5% bupivacaine with epinephrine 1:200,000, on pain control following total knee arthroplasty (TKA). Forty patients were randomly distributed into 2 groups: Group A received general anesthesia plus a FNB (n = 19), whereas Group B received general anesthesia plus a FNB with 30 mL of preservative-free saline (n = 21). The amount of morphine used, sedation, and average pain perception were measured for the first 24 hours and daily postoperatively. Group A used significantly less morphine (48.1 mg) compared with Group B, which used 76.2 mg during the first 24 hours after surgery (P = 0.003). Group A's sedation scale was significantly less than group B's (2.26 vs 2.67) (P = 0.045). The average pain perception was significantly different (P =.002). Postoperative management of pain following TKA can be improved through a preoperative single-injection FNB with 0.5% bupivacaine plus epinephrine 1:200,000. The cost is minimal, risks appear acceptable, and the procedure is efficacious.
authors.affiliation: Orthopedic Center, Easton, Maryland 21601, USA.
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Szczukowski
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hines
authors.forename: John A
authors.initials: JA
authors.lastname: Snell
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Sisca
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D002045:Bupivacaine; D004837:Epinephrine