title: [Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study].
abstract: OBJECTIVE
  Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty.
  
  
  METHODS
  46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group); in 24 patients, epidural analgesia was done (PCEA group). The analgesic effects, side effects, articular recovery and complications were compared between two groups.
  
  
  RESULTS
  At 6h and 12h after surgery, the knee pain score (VAS score) during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group.
  
  
  CONCLUSIONS
  Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6h and 12h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.
authors.affiliation: Departamento de Anestesiologia Shanghai Tenth People's Hospital, Tongji University School of Medicine, Xangai, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Wang
authors.affiliation: Departamento de Anestesiologia Shanghai Tenth People's Hospital, Tongji University School of Medicine, Xangai, China.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Liu
authors.affiliation: Departamento de Anestesiologia Shanghai Tenth People's Hospital, Tongji University School of Medicine, Xangai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Departamento de Anestesiologia Shanghai Tenth People's Hospital, Tongji University School of Medicine, Xangai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Departamento de Anestesiologia, Tongji Hospital, Tongji University School of Medicine, Xangai, China.
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: Zhang
authors.affiliation: Departamento de Anestesiologia Shanghai Tenth People's Hospital, Tongji University School of Medicine, Xangai, China. Electronic address: liquan0508@yeah.net.
authors.forename: Quan
authors.initials: Q
authors.lastname: Li
keywords: Arthroplasty; Artroplastia; Bloqueio femoral contínuo; Continuous femoral nerve block; Estimulador de nervo; Joelho; Knee; Nerve stimulator; Replacement; Substituição; Ultrasound; Ultrassom