Pain management in total knee arthroplasty by intraoperative local anesthetic application and one-shot femoral block

Sigirci, Aykut

doi:10.4103/0019-5413.205688

Cited by 13 publications

(8 citation statements)

References 23 publications

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“…5 The nerve supply of the leg and foot is from the sciatic nerve (tibial nerve and peroneal nerves), except the skin on the medial aspect is supplied by the sensory saphenous nerve. 6,7,4…”

Section: Relevant Anatomymentioning

confidence: 99%

Comparison of Analgesic Outcome of Ultrasound Guided Distal Adductor Canal Block with Proximal Adductor Canal Block for Patients Undergoing Unilateral Total Knee Replacement- A Prospective Single Blinded Study

Vijay¹,

Kumari²,

Jayaraman³

2019

jebmh

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BACKGROUND Continuous epidural analgesia is the gold standard for postoperative analgesia for lower limb surgeries. But it needs strict patient monitoring as it can cause hypotension, opioid induced bradycardia, delayed mobility due to dense motor block, leading to long hospital stay which in turn makes the patient prone for nosocomial infections and DVT. Other modes of analgesia include femoral nerve block but this leads to quadriceps weakness leading to delayed mobility and patient discharge. METHODS We describe two different sites of injections of drug into adductor canal that is upper adductor canal and lower adductor canal to evaluate adequate analgesia. 100 patients posted for unilateral TKR was selected randomly. Block was performed post-operatively. Group A patients received distal adductor canal block and group B patients received proximal adductor canal block. Both the groups of patients received 0.25% bupivacaine 40 ml. Painless time after giving block was noted by the ICU staff who was blinded and the total amount of analgesia required in 24 hours was noted along with the VAS score at 12 Hrs and 24 Hrs after surgery. RESULTS Lower adductor canal block provided better analgesia with a VAS score significantly less at 12 hrs and 24 hrs and also the painless time in hours was significantly more in group A patients. We also noticed that the analgesic requirement in group A patients was less compared to group B at 0.01 level 99% sign. CONCLUSIONS Lower adductor canal block provided better analgesic outcome in patients undergoing unilateral TKR in the acute postoperative period.

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“…5 The nerve supply of the leg and foot is from the sciatic nerve (tibial nerve and peroneal nerves), except the skin on the medial aspect is supplied by the sensory saphenous nerve. 6,7,4…”

Section: Relevant Anatomymentioning

confidence: 99%

Comparison of Analgesic Outcome of Ultrasound Guided Distal Adductor Canal Block with Proximal Adductor Canal Block for Patients Undergoing Unilateral Total Knee Replacement- A Prospective Single Blinded Study

Vijay¹,

Kumari²,

Jayaraman³

2019

jebmh

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“…After knee surgery, pain inhibits early rehabilitation & mobilization of [11] the knee joint. This acute post-surgical pain is also a known predictor [24] of chronic post total knee arthroplasty pain .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Post-Operative Analgesic Efficacy of Local Infiltration Analgesia in Patients Undergoing Total Knee Arthroplasty -a Prospective Randomized Study

Garg¹,

Chouhan²,

Pandey³

et al. 2020

ijsr

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Introduction – Total knee arthroplasty is considered as one of the most painful procedures in field of orthopedic surgery. In this study we intended to evaluate the analgesic efficacy of Local Infiltration Analgesia (LIA) with post-surgical single shot of adductor canal block in terms of good post-operative analgesia and early post- operative mobilization thus allowing faster rehabilitation and recovery and thereby improving the final outcome of TKA in long term. Material and method- A total of 60 patients were enrolled, 30 in each group. Group A received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine along with intraoperative local infiltration analgesia. Group B also received Standard General anesthesia & postoperative analgesia with a single shot of adductor canal block with 20cc of 0.25% ropivacaine but intraoperative local infiltration analgesia was not administered in group B. Result- Group B patients required a greater number of rescue analgesic doses in comparison to Group A patients. The majority of the patients in Group A had early postoperative mobilization in comparison to Group B (p=0.003). Mean preoperative and 6-week postoperative WOMAC scores showed that difference was statistically significant (p=0.034), showing a significantly lower 6-week postoperative WOMAC score in Group A in comparison to Group B. Conclusion – Our study gives us a conclusion that intraoperative Local Infiltration Analgesia along with single shot of adductor canal block provides better post-operative pain relief & allows early mobilization of the patient thus enhancing the rehabilitation thereby improving the final outcome of the Total Knee Arthroplasty.

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“…Fringe blockings are related to the littlest rate of security impacts and difficulties when contrasted with the spinal anaesthesia and absence of pain controlled by the patients [5][6][7].…”

Section: Commentarymentioning

confidence: 99%

“…The femoral nerve is situated in the leg that gives sensation to the front of the thigh and part of the lower leg. Brokenness of the femoral nerve is by and large because of direct damage (injury), delayed weight on the nerve, and pressure of the nerve by adjacent parts of the body or infection [3][4][5].…”

Section: Commentarymentioning

confidence: 99%

Impact of Femoral Nerve Obstruct for Torment Alleviation Post Knee Substitution

saad¹

2017

Vasc Med Surg

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Pain management in total knee arthroplasty by intraoperative local anesthetic application and one-shot femoral block

Cited by 13 publications

References 23 publications

Comparison of Analgesic Outcome of Ultrasound Guided Distal Adductor Canal Block with Proximal Adductor Canal Block for Patients Undergoing Unilateral Total Knee Replacement- A Prospective Single Blinded Study

Comparison of Analgesic Outcome of Ultrasound Guided Distal Adductor Canal Block with Proximal Adductor Canal Block for Patients Undergoing Unilateral Total Knee Replacement- A Prospective Single Blinded Study

Evaluation of Post-Operative Analgesic Efficacy of Local Infiltration Analgesia in Patients Undergoing Total Knee Arthroplasty -a Prospective Randomized Study

Impact of Femoral Nerve Obstruct for Torment Alleviation Post Knee Substitution

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