Effects of a preoperative femoral nerve block on pain management and rehabilitation after total knee arthroplasty.
The objective of this prospective, randomized, double-blind study was to determine if preoperative administration of a femoral nerve block reduces the amount of morphine needed for postoperative analgesia after total knee arthroplasty (TKA). Forty-two patients undergoing TKA were randomly assigned to receive either a femoral nerve block (0.50% bupivacaine hydrochloride with epinephrine 1:200,000) or matching placebo. Results showed postoperative morphine use was significantly lower in patients who received the nerve block (25.5 vs 37.5 mg, P = .016); however, the 2 groups had similar pain scores and rehabilitative outcomes. In general, a preoperative femoral nerve block is a safe and effective adjunct for decreasing morphine use for post-TKA analgesia.
Good
Robert P
RP
Bryn Mawr Hospital, Bryn Mawr, PA 19010, USA. rpg@orthspec.com
Snedden
Michael H
MH
Schieber
Frank C
FC
Polachek
Andrea
A
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D002045:Bupivacaine / Q000008:administration & dosage; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002045:Bupivacaine; D004837:Epinephrine