title: Ultrasound-guided single-injection femoral nerve block provides effective analgesia after total knee arthroplasty up to 48 hours.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the effects of ultrasound (US) guided single-injection femoral nerve block (FNB) spinal anesthesia on pain control, morphine consumption, adverse effects, and patient satisfaction during the postoperative 48-hour period in patients undergoing total knee arthroplasty (TKA).
  
  
  METHODS
  One hundred four ASA physical status I-III patients undergoing single TKA for degenerative joint disease were enrolled in this clinical study. Patients were randomly distributed into two groups: US-guided single-injection FNB with 40 ml of 0.5% bupivacaine and 1:200,000 epinephrine was administered to Group F (n=51) patients. Preservative-free saline was injected in Group P (n=53) patients using the same method as Group F. Pain scores, morphine consumption, incidences of adverse events, and patient satisfaction were assessed over the course of 48 hours.
  
  
  RESULTS
  Group F used significantly less morphine compared with Group P (18.7 mg vs. 39.6 mg) during the first 48 hours after surgery (p<0.001). When compared with group P, the VRS scores both at rest and during movement were significantly lower in Group F at 4, 8, 12, 24, and 48 hours after TKA (for all comparisons p<0.001). In addition, patient satisfaction was better in Group F than Group P.
  
  
  CONCLUSIONS
  This study suggests that a US-guided single-injection femoral nerve block following TKA improves patient satisfaction and reduces consumption of morphine during the first 48 hours.
authors.affiliation: Department of Anesthesiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey. drlsahin@hotmail.com.
authors.forename: Levent
authors.initials: L
authors.lastname: Sahin
authors.affiliation: Department of Anesthesiology, Kütahya State Hospital, Kütahya, Turkey.
authors.forename: Halil Fatih
authors.initials: HF
authors.lastname: Korkmaz
authors.affiliation: Department of Anesthesiology, 75. Yıl State Hospital, Gaziantep, Turkey.
authors.forename: Mehrican
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Department of Anesthesiology, Elazığ State Hospital, Elazığ, Turkey.
authors.forename: Güneri
authors.initials: G
authors.lastname: Atalan
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine