Impact of a preemptive multimodal analgesia plus femoral nerve blockade protocol on rehabilitation, hospital length of stay, and postoperative analgesia after primary total knee arthroplasty: a controlled clinical pilot study.
OBJECTIVE
To compare preemptive multimodal analgesia (PMMA) without femoral nerve blocks (FNB) to PMMA including FNB following total knee arthroplasty (TKA).


METHODS
In a prospective, controlled pilot study, subjects with noninflammatory arthritis undergoing TKA and a short postoperative stay received either PMMA + FNB (FNB group; n = 19) or PMMA only (PMMA group; n = 20). No preoperative group differences were noted. Evaluations occurred in hospital and at 2, 6, and 12 weeks postoperatively. The primary outcome (knee flexion) was measured on day two postoperatively. Rehabilitation indices, pain, analgesic use, and length of stay (LOS) were also measured.


RESULTS
All subjects completed the study. The only significant group differences were quadriceps motor blocks in the FNB group (P < 0.001). No significant differences were noted in ROM, pain levels, analgesic use, or hospital LOS.


CONCLUSIONS
Other than the quadriceps motor block, no group differences were noted; both achieved satisfactory analgesia. Best postoperative pain management strategies when following a short hospital stay program are still unclear.
Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada. lauren.beaupre@ualberta.ca
Lauren A
LA
Beaupre
D Bill C
DB
Johnston
Sherry
S
Dieleman
Ban
B
Tsui
D000368:Aged; D000698:Analgesia; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies; D012046:Rehabilitation