title: Outpatient unicompartment knee arthroplasty with indwelling femoral nerve catheter.
abstract: Contemporary multimodal anesthesia regimens allow the performance of unicompartment knee arthroplasty (UKA) on an outpatient basis. Our initial pilot experience is presented using a continuous femoral nerve block as an adjunct for 24 patients classified as American Society of Anesthesiology class 1 (14 men, 10 women; median age, 56 years; range, 46-72 years). After minimally invasive UKA, patients documented their pain and oral medication use while at home for the first 5 days. Adverse events, medication adverse effects, and the amount of infused ropivacaine were recorded. Median pain scores for the first 3 days were 1, 2, and 2 (at rest) and 4, 5, and 3 (during physical therapy). Eighteen patients (75%) required less than 4 mg oral hydromorphone/d. Of the 18, 10 (42%) did not require supplemental oral opioids. The median catheter use was 3 days. Our results suggest that with careful patient selection and adequate teaching, continuous femoral nerve blocks may be used as part of a multimodal pain regimen to assist the delivery of outpatient UKA with high patient satisfaction.
authors.affiliation: Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Geoffrey F
authors.initials: GF
authors.lastname: Dervin
authors.forename: Susan M
authors.initials: SM
authors.lastname: Madden
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Crawford-Newton
authors.forename: Alan T
authors.initials: AT
authors.lastname: Lane
authors.forename: Holly C
authors.initials: HC
authors.lastname: Evans
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000577:Amides / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling; D003131:Combined Modality Therapy; D005267:Femoral Nerve / Q000187:drug effects; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D009407:Nerve Block / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010045:Outpatients; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D018579:Patient Selection; D010865:Pilot Projects; D012189:Retrospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D004091:Hydromorphone