title: Comparing the effects of single shot sciatic nerve block versus posterior capsule local anesthetic infiltration on analgesia and functional outcome after total knee arthroplasty: a prospective, randomized, double-blinded, controlled trial.
abstract: Peripheral nerve blocks appear to provide effective analgesia for patients undergoing total knee arthroplasty. Although the literature supports the use of femoral nerve block, addition of sciatic nerve block is controversial. In this study we investigated the value of sciatic nerve block and an alternative technique of posterior capsule local anesthetic infiltration analgesia. 100 patients were prospectively randomized into three groups. Group 1: sciatic nerve block; Group 2: posterior local anesthetic infiltration; Group 3: control. All patients received a femoral nerve block and spinal anesthesia. There were no differences in pain scores between groups. Sciatic nerve block provided a brief clinically insignificant opioid sparing effect. We conclude that sciatic nerve block and posterior local anesthetic infiltration do not provide significant analgesic benefits.
authors.affiliation: Department of Anesthesia, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Ben
authors.initials: B
authors.lastname: Safa
authors.affiliation: Department of Orthopedics, Holland Orthopedic and Arthritic Institute, Toronto, ON, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gollish
authors.affiliation: Department of Anesthesia, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Lynn
authors.initials: L
authors.lastname: Haslam
authors.affiliation: Department of Anesthesia, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
authors.forename: Colin J L
authors.initials: CJ
authors.lastname: McCartney
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D017746:Joint Capsule; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012584:Sciatic Nerve / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local
keywords: analgesia; peripheral nerve block; posterior capsule local anesthetic infiltration; sciatic nerve block; total knee arthroplasty (TKA)