title: Combined femoral and sciatic nerve block vs combined femoral and periarticular infiltration in total knee arthroplasty: a randomized controlled trial.
abstract: This study tests the null hypothesis that there is no difference between sciatic nerve block (SNB) and periarticular anesthetic infiltration (PI) as adjuncts to femoral nerve blockade (FNB) in total knee arthroplasty in terms of postoperative opioid requirements. Fifty-two patients undergoing total knee arthroplasty were randomized to receive either (a) combined FNB-SNB or (b) combined FNB-PI. Average morphine consumption in the first 24 (20 vs 23 mg) and 48 hours (26 vs 33 mg) showed no significant difference. Visual Analogue Scale scores, knee flexion (60° vs 67.5°) and extension lag (0° vs 5°) were comparable. Anesthetic time, surgical time, and length of hospital stay (5.5 vs 6 days) were similar. This study showed no significant difference between the 2 groups. The PI offers a practical and potentially safer alternative to SNB.
authors: Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom.
authors: Devendra
authors: D
authors: Mahadevan
authors: Richard P
authors: RP
authors: Walter
authors: Gary
authors: G
authors: Minto
authors: Thomas C
authors: TC
authors: Gale
authors: Christoph J
authors: CJ
authors: McAllen
authors: Matthew
authors: M
authors: Oldman
mesh_terms: D000368:Aged; D000698:Analgesia / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D007902:Length of Stay; D000077554:Levobupivacaine; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D012584:Sciatic Nerve
chemical_list: D009020:Morphine; D000077554:Levobupivacaine; D002045:Bupivacaine