title: Continuous femoral nerve block versus patient-controlled analgesia following total knee arthroplasty.
abstract: OBJECTIVE
  To compare total knee arthroplasty (TKA) patients who received continuous femoral nerve block (FNB) with local anaesthetics through a catheter versus patient-controlled analgesia (PCA) with intravenous morphine.
  
  
  METHODS
  50 women and 10 men aged 51 to 84 years with matched characteristics underwent TKA and received either continuous FNB with local anaesthetics through a catheter (n=30) or PCA with intravenous morphine (n=30). None of the patients had had previous knee surgery. All operations were performed according to the standard protocol. Daily mean pain numerical rating scale at rest (NRS-R) and during movement (NRS-M), requirement of extra pain control, complications related to pain control, and overall patient satisfaction in both groups were compared.
  
  
  RESULTS
  Both groups were similar in terms of pain NRS-R and NRS-M, overall satisfaction, and length of hospital stay. Within each group, pain NRS-M score was significantly higher than pain NRS-R score. In the FNB group, 3 patients had dislodgement of the femoral catheter on day 1 and switched to PCA with intravenous morphine. Two of them had fair satisfaction. Patients in the PCA group had significantly more side-effects (nausea, vomiting, dizziness, and pruritis); 2 of the 5 patients with nausea and vomiting had fair satisfaction. No patients had any surgical complication.
  
  
  CONCLUSIONS
  Both FNC and PCA provide reliable pain control.
authors.affiliation: Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong. charlesnfy@gmail.com
authors.forename: Fu-Yuen
authors.initials: FY
authors.lastname: Ng
authors.forename: Kwong-Yuen
authors.initials: KY
authors.lastname: Chiu
authors.forename: Chun Hoi
authors.initials: CH
authors.lastname: Yan
authors.forename: Kwok-Fu Jacobus
authors.initials: KF
authors.lastname: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*