title: Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial.
abstract: Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB) or intravenous patient controlled analgesia (group PCIA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P < 0.05). Analgesic rescue medications were significantly reduced in patients receiving CFNB (P < 0.001 and P = 0.031, resp.). Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.
authors.affiliation: The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
authors.forename: Lihua
authors.identifier: 0000-0002-5202-910X
authors.initials: L
authors.lastname: Peng
authors.affiliation: The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ren
authors.affiliation: The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Qin
authors.affiliation: The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Institute of Clinical Trials, The First Affiliated Hospital of Chongqing Medical University, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Feng
authors.affiliation: The Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, China.
authors.forename: Haidan
authors.initials: H
authors.lastname: Lin
authors.affiliation: The Department of Anesthesia and Pain Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Road Youyi Road, Yuanjiagang Community, Yuzhong District, Chongqing 400016, China.
authors.forename: Min
authors.initials: M
authors.lastname: Su