title: Single-injection femoral and sciatic nerve blocks for pain control after total knee arthroplasty.
abstract: This study was designed to evaluate the addition of a single-injection sciatic nerve block to a femoral nerve block for analgesia after total knee arthroplasty. Fifty-seven patients undergoing primary total knee arthroplasty were randomized to receive femoral nerve blockade or a sham block. A subsequent 31 patients received both femoral and sciatic nerve blocks (FSNBs) before general anesthesia. Intravenous morphine use and visual analog pain scale scores were recorded at regular intervals. Femoral and sciatic nerve blocks were placed in less than five minutes, on average. Lower visual analog pain scale scores were noted in both femoral nerve blockade and FSNB groups compared to shams through 48 hours. Morphine use was significantly lower in the FSNB group. Femoral and sciatic nerve block can be placed quickly and consistently in the operating room with improved postoperative pain relief and reduced narcotic consumption.
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: Michael H
authors.initials: MH
authors.lastname: Bourne
authors.forename: E Marc
authors.initials: EM
authors.lastname: Mariani
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000779:Anesthetics, Local; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001340:Autonomic Nerve Block / Q000009:adverse effects / Q000379:methods*; D002045:Bupivacaine; D004305:Dose-Response Relationship, Drug; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D012584:Sciatic Nerve; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine