title: Local Infiltration Analgesia Versus Continuous Femoral Nerve Block in Pain Relief After Total Knee Arthroplasty: A Randomized Controlled Trial.
abstract: BACKGROUND
  Although both local infiltration analgesia (LIA) and continuous femoral nerve block (FNB) are common analgesic modalities for pain relief after total knee arthroplasty (TKA), we are aware of no parallel-group, randomized controlled trial that has solely compared the efficacy of LIA and continuous FNB.
  
  
  METHODS
  We conducted a prospective, 2-arm, parallel-group, randomized controlled trial involving patients scheduled for TKA. A total of 45 patients were randomly assigned to either the LIA or the continuous FNB group. Except for the analgesic modality, perioperative managements were identical in both groups. The primary outcome was postoperative pain score at rest 1 day after surgery, measured using a 100-mm visual analog scale.
  
  
  RESULTS
  Patients in the LIA group had a significantly lower visual analog scale score at rest 1 day after surgery than those in the continuous FNB group (34 ± 10 vs 42 ± 13 mm; P = .028). The opioid consumption during the initial 24 hours was significantly lower in the LIA group (12 ± 4 vs 16 ± 7 mg; P = .031). There were no differences in the rate of complications between the groups.
  
  
  CONCLUSIONS
  LIA was associated with better pain relief with a comparable complications rate for patients undergoing TKA than FNB. We recommend LIA for pain relief after TKA.
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kurosaka
authors.affiliation: Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, Mito, Ibaraki, Japan.
authors.forename: Sachiyuki
authors.initials: S
authors.lastname: Tsukada
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Seino
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Morooka
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects; D006801:Humans; D007267:Injections; D007902:Length of Stay; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local
keywords: knee; pain management; periarticular injection; peripheral nerve blockade; total knee arthroplasty