title: Postoperative analgesic efficacy of fascia iliaca block versus periarticular injection for total knee arthroplasty.
abstract: OBJECTIVE
  This study evaluated the postoperative analgesic efficacies of fascia iliaca block and periarticular drug injection techniques after TKA (total knee arthroplasty) surgeries.
  
  
  METHODS
  Prospective, randomized clinical trial.
  
  
  METHODS
  University Teaching and Research Center.
  
  
  METHODS
  Seventy-one American Society of Anesthesiologists (ASA) I-III patients between 48 and 70 years of age who underwent total knee arthroplasty were randomized.
  
  
  METHODS
  Tenoxicam (20 mg) was administered intramuscularly to both groups of patients 30 minutes before surgery. Patients were randomized into two groups to receive fascia iliaca block before the induction of anesthesia (Group FI) or periarticular drug injection during the surgery (Group PI). All surgeries were performed under general anesthesia using standard techniques. Postoperative analgesia was provided with patient-controlled intravenous morphine.
  
  
  METHODS
  Total morphine consumption was the primary outcome measure and was recorded postoperatively at 1, 2, 6, 12 and 24 hours. Pain levels at rest and on movement (knee flexion) were evaluated using the Visual Analogue Scale (VAS) and recorded at the same time points. Patients' demographics, rescue analgesic demands, side effects, hemodynamics, and satisfaction scores were also recorded.
  
  
  RESULTS
  The groups had similar VAS scores both at rest and on movement (P>.05). However, the amount of cumulative morphine and use at each follow-up period was higher in Group PI (P<.0001). The groups did not differ significantly in rescue analgesic use or side effects, such as nausea/vomiting, hemodynamic variables, and patient satisfaction scores (P>.05).
  
  
  CONCLUSIONS
  Fascia iliaca block may be used as an alternative method to periarticular injection, and it effectively reduces the amount of morphine used to relieve post-TKA pain.
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana Teaching and Research Center, Adana, Turkey; Baskent Universitesi Tip Fakultesi Adana Uygulama ve Arastirma Merkezi Dadaloglu, Mh.39. Sk. No.6 01250, Yuregir, Adana, Turkiye. Electronic address: caglaetike@hotmail.com.
authors.forename: Cagla
authors.initials: C
authors.lastname: Bali
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana Teaching and Research Center, Adana, Turkey; Baskent Universitesi Tip Fakultesi Adana Uygulama ve Arastirma Merkezi Dadaloglu, Mh.39. Sk. No.6 01250, Yuregir, Adana, Turkiye.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ozmete
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana Teaching and Research Center, Adana, Turkey; Baskent Universitesi Tip Fakultesi Adana Uygulama ve Arastirma Merkezi Dadaloglu, Mh.39. Sk. No.6 01250, Yuregir, Adana, Turkiye.
authors.forename: H Evren
authors.initials: HE
authors.lastname: Eker
authors.affiliation: Baskent Universitesi Tip Fakultesi Adana Uygulama ve Arastirma Merkezi Dadaloglu, Mh.39. Sk. No.6 01250, Yuregir, Adana, Turkiye; Baskent University School of Medicine, Department of Orthopedics and Traumatology, Adana Teaching and Research Center, Adana, Turkey.
authors.forename: Murat A
authors.initials: MA
authors.lastname: Hersekli
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana Teaching and Research Center, Adana, Turkey; Baskent Universitesi Tip Fakultesi Adana Uygulama ve Arastirma Merkezi Dadaloglu, Mh.39. Sk. No.6 01250, Yuregir, Adana, Turkiye.
authors.forename: Anis
authors.initials: A
authors.lastname: Aribogan
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage; D005205:Fascia / Q000187:drug effects; D006801:Humans; D007270:Injections, Intra-Articular; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine
keywords: Fascia iliaca block; Periarticular drug injection; Total knee arthroplasty