Femoral nerve inguinal approach versus proximal femoral triangle ap proach for continuous regional analgesia in active rehabilitation after total knee arthroplasty: A prospective, randomised study

Guilley, Jérôme; Besancon, Isabelle; Hivert, Antoine; Plouhinec, Anne Marine; Oudot, Mathieu; Venet, Guillaume; Fraquet, N.; Cousin, Julien; Planche, Lucie; Ganière, Catherine; Duchalais, Alexis

doi:10.1016/j.accpm.2022.101043

Cited by 1 publication

(2 citation statements)

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Section: Discussionsupporting

confidence: 78%

“…However, ACB showed superiority over FNB only in terms of postoperative 24-hour quadriceps strength and completion of the TUG test. There were nonsignificant statistical differences in NRS scores between the FNB group and the FTB group at any time point, while FTB significantly preserved muscle strength compared with the FNB, are similar to those of Jerome Guilley et al 20,21 The FN is a major sensory nerve in the thigh, supplying the anterior aspect of the thigh, the knee joint, and the anterior and medial aspects of the lower leg. FNB performed at the level of the IL can comprehensively block the FN and cover a wider area of nerve distribution, thus providing more comprehensive pain relief.…”

Section: Discussionsupporting

confidence: 74%

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Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty

Tan,

Chen,

et al. 2024

The Clinical Journal of Pain

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Objectives: This study aimed to compare the analgesic effects of continuous femoral nerve block (FNB), femoral triangle block (FTB), and adductor canal block (ACB) following total knee arthroplasty (TKA). The goal was to identify the most effective nerve block technique among these three. Methods: Patients undergoing TKA were randomly assigned to one of three groups: FNB, FTB, or ACB. Nerve blocks were administered preoperatively, with catheters placed for patient-controlled nerve analgesia (PCNA). The primary endpoint was the Numeric Rating Scale (NRS) score at movement at 24 hours post-surgery. Secondary endpoints included NRS scores at rest and movement, quadriceps strength, Timed Up and Go (TUG) test performance, range of motion (ROM), effective PCNA utilization, and opioid consumption at various post-surgery time points. Results: Of the 94 valid datasets analyzed (FNB: 31, FTB: 31, ACB: 32), significant differences were observed in the primary endpoint (H=7.003, P=0.03). Post-hoc analysis with Bonferroni correction showed that the FNB group had a significantly lower median pain score (3 [2-4]) compared to the ACB group (4 [3-5], Bonferroni-adjusted P=0.03). Regarding secondary endpoints, both the FNB and FTB groups had lower NRS scores than the ACB group at various time points after surgery. Quadriceps strength and TUG completion were better in the FTB and ACB groups. There were no statistically significant differences among the groups for the other endpoints. Discussion: Continuous FTB provides postoperative analgesia comparable to FNB, but with the advantage of significantly less impact on quadriceps muscle strength, a benefit not seen with FNB. Both FTB and ACB are effective in preserving quadriceps strength postoperatively.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 74%