title: Femoral nerve block: Assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  Knee anterior cruciate ligament reconstruction (ACLR) may be painful in the postoperative period. The primary objective of this study was to evaluate whether the use of femoral nerve block (FNB) associated with spinal anesthesia would improve the postoperative pain treatment in ACLR and the secondary objectives were to evaluate tramadol request and adverse events.
  
  
  METHODS
  53 patients were randomly divided into two groups: GA (n =26) received spinal anesthesia and GB (n = 27) received spinal anesthesia and FNB. All patients received multimodal analgesia and rescue analgesics could be requested anytime. Assessments were performed at 6, 12 and 24 hours.
  
  
  RESULTS
  There was no difference between both groups regarding demographic and clinical- surgical variables. There was no difference between groups regarding pain intensity. Mean pain scores were higher at 12 hours in GA and there was no change in GB; 55.6% of patients reported moderate pain in GA and 53.8% mild pain in GB. There was no difference regarding tramadol request. There were no serious adverse events: 80.8% of patients in GB had motor block of the thigh and two fell.
  
  
  CONCLUSIONS
  Analgesia was more effective with the combination of spinal and FNB, which allowed better control of postoperative pain, assessed 12 hours after anesthesia. There was no difference in tramadol request. Patients in this study had no serious adverse events; however, one must be attentive to motor paralysis and the possibility of falling when FNB is performed.
authors.affiliation: Post-Graduation Program in Surgery, Universidade Federal do Paraná, Curitiba, PR, Brazil; Service of Anesthesiology, Hospital do Trabalhador, Curitiba, PR, Brazil; Trate a Dor, Curitiba, PR, Brazil. Electronic address: ursulaguirro@gmail.com.
authors.forename: Ursula Bueno do Prado
authors.initials: UB
authors.lastname: Guirro
authors.affiliation: Discipline of Anesthesiology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil; Service of Anesthesiology, Hospital Santa Casa de Curitiba, Curitiba, PR, Brazil.
authors.forename: Elizabeth Milla
authors.initials: EM
authors.lastname: Tambara
authors.affiliation: Department of Medical Residence, Hospital Santa Casa de Curitiba, Curitiba, PR, Brazil.
authors.forename: Fernanda Reinaldi
authors.initials: FR
authors.lastname: Munhoz
mesh_terms: D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects; D010149:Postoperative Pain / Q000628:therapy*
keywords: Adverse event; Anterior cruciate ligament reconstruction; Femoral nerve block; Postoperative analgesia; Spinal anesthesia; Tramadol