title: Effectiveness of femoral nerve blockade for pain control after total knee arthroplasty.
abstract: Control of postoperative pain is a major concern for patients undergoing total knee arthroplasty (TKA). The purpose of this study was to investigate pain control and opioid use, as well as length of stay, ambulation time, antiemetic use, and degree of mobilization for patients undergoing total knee arthroplasty, comparing those receiving femoral nerve block (FNB) to those receiving no femoral nerve block. Using retrospective patient record data, 133 subjects from an acute care community hospital in western Canada were split into three groups: no FNB (control group, n = 49), single-shot FNB (n = 33), and continuous FNB (n = 51). There was a statistically significant improvement in pain control on day of surgery for the FNB group compared with the no-FNB group, and reduction in opioid usage on days 0, 1, and 2 in the continuous FNB group compared with the no-FNB and single-shot group. Also noted was a statistically significant reduction in antiemetic use in the FNB compared with the no-FNB group on the day after surgery. This study is in accordance with earlier studies that support continuous FNB as an effective method for achieving postoperative pain control and reducing opioid use for patients undergoing TKA.
authors.affiliation: Victoria General Hospital, Winnipeg, Manitoba, Canada. vduarte@mts.net
authors.forename: Victor M
authors.initials: VM
authors.lastname: Duarte
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Fallis
authors.forename: Dean
authors.initials: D
authors.lastname: Slonowsky
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Kwarteng
authors.forename: Colin K L
authors.initials: CK
authors.lastname: Yeung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002170:Canada; D005260:Female; D005267:Femoral Nerve; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid