title: Safety and efficacy of continuous femoral nerve catheter with single shot sciatic nerve block vs epidural catheter anesthesia for same-day bilateral total knee arthroplasty.
abstract: In a retrospective analysis, we evaluated the safety and efficacy of peripheral nerve blocks (PNB) compared to epidural anesthesia in 221 consecutive patients undergoing same-day bilateral total knee arthroplasty (TKA). Primary outcome measures included: hypotension requiring physician intervention, number of blood transfusions, perioperative hespan and crystalloid consumption, incidences of respiratory desaturation, pruritis, urinary retention, and nausea/vomiting. The incidences of hypotension, urinary retention, and pruritis were all higher in the epidural group, compared to PNB. Epidural patients also required more blood transfusions and greater volumes of hespan and crystalloid. PNB are safe and efficacious modality of analgesia for same day bilateral TKA and provide adequate pain relief with a significant decrease in postoperative complications compared to epidural anesthesia.
authors.affiliation: Drexel Orthopaedics, Philadelphia, PA.
authors.forename: Nimit
authors.initials: N
authors.lastname: Patel
authors.affiliation: NYU Hospital for Joint Disease, New York, NY.
authors.forename: Olga
authors.initials: O
authors.lastname: Solovyova
authors.affiliation: Department of Statistics, Storrs, CT.
authors.forename: Greg
authors.initials: G
authors.lastname: Matthews
authors.affiliation: Woodland Anesthesiology Associates, Hartford, CT.
authors.forename: Sivasenthil
authors.initials: S
authors.lastname: Arumugam
authors.affiliation: Woodland Anesthesiology Associates, Hartford, CT.
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Sinha
authors.affiliation: Connecticut Joint Replacement Institute, Saint Francis Hospital, Hartford, CT.
authors.forename: Courtland G
authors.initials: CG
authors.lastname: Lewis
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures; D000767:Anesthesia, Epidural; D019645:Arthroplasty, Replacement, Knee; D002404:Catheterization; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D012189:Retrospective Studies; D012584:Sciatic Nerve / Q000187:drug effects*; D016896:Treatment Outcome
keywords: bilateral total knee; epidural; peripheral nerve block; safety; same-day