Multimodal periarticular injection vs continuous femoral nerve block after total knee arthroplasty: a prospective, crossover, randomized clinical trial.
This study compares the efficacy of pain control using continuous femoral nerve block (FNB) and multimodal periarticular soft tissue injection. This is a randomized, crossover, clinical trial. Sixteen patients having bilateral osteoarthritis of the knee scheduled for staged total knee arthroplasty were randomized to receive either FNB (0.2% ropivacaine), via indwelling catheter for 72 hours, or multimodal periarticular soft tissue injection in the first stage. In the second stage, they received the opposite treatment. The primary outcome measure was morphine consumption by patient-controlled analgesia in the first 72 hours postoperatively. Cumulative morphine consumption as well as rest pain and motion pain in the first 72 hours was comparable between the 2 groups. The functional outcomes did not differ significantly. We conclude that multimodal periarticular soft tissue injection provides comparable analgesia to continuous FNB after total knee arthroplasty.
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong.
Fu-Yuen
FY
Ng
Jacobus Kwok-Fu
JK
Ng
Kwong-Yuen
KY
Chiu
Chun-Hoi
CH
Yan
Chi-Wing
CW
Chan
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage* / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002408:Catheters, Indwelling; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077212:Ropivacaine