The preemptive effect of single shot, the 3 in 1 femoral nerve block with ropivacaine 0.375% on postoperative morphine consumption in elderly patient after unilateral total knee replacement

Özen, Mehmet Özgün; İnan, Nurten; Tümer, Filiz; Uyar, Ahmet Şenol; Baltaci, Bülent

doi:10.1016/j.rapm.2004.07.196

Cited by 12 publications

(16 citation statements)

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“…There is no benefit from the addition of a singleinjection sciatic nerve block to FNB in patients undergoing TKR [1]. The results of our study, which concur with findings from other studies, show that FNB is adequate by itself to provide analgesia in TKR and ACL reconstruction for the first 10 hours after the block is performed [7,8,17].…”

Section: Discussionsupporting

confidence: 88%

“…Increased local anesthetic volume or different concentrations do not influence block quality or analgesia duration with FNB during knee surgery [5,12]. However, other studies have reported just the opposite [6,17]. The large volume of anesthetic (40 mL) and the technique used for the FNB in the present study may be responsible for the efficacy of the block with the low concentrations of anesthetics given.…”

Section: Discussionmentioning

confidence: 58%

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Single-injection femoral nerve block with 0.25% ropivacaine or 0.25% bupivacaine for postoperative analgesia after total knee replacement or anterior cruciate ligament reconstruction

Souza

Correa

Henriques

et al. 2008

Journal of Clinical Anesthesia

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 58%

Single-injection femoral nerve block with 0.25% ropivacaine or 0.25% bupivacaine for postoperative analgesia after total knee replacement or anterior cruciate ligament reconstruction

Souza

Correa

Henriques

et al. 2008

Journal of Clinical Anesthesia

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“…Nine patients didn't need any analgesic tablets postoperatively and for three days after operation (5 subjects in bupivacaine group and 4 subjects in ropivacaine group); mean number of analgesic tablets consumed over 3 days was nearly equal for two groups. This study showed that ropivacaine did not differ from bupivacaine with respect to postoperative rescue analgesic requirement as reported by other authors [35,[42][43][44][45] who found that the increased duration of analgesia with long acting anaesthetics reduces the analgesic consumption after third molar surgery. Interestingly, a study of patients undergoing lower limb surgery who received ropivacaine hydrochloride for operative anaesthesia reported no use of supplemental analgesia in the first 24 hours after surgery by 37% of the patients.…”

Section: Discussionsupporting

confidence: 86%

Ropivacaine versus Bupivacaine in Postoperative Pain Control

Mansour¹

2012

J Biotechnol Biomaterial

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Objective: The aim of this study was to compare between 2 types of long acting anesthetics: bupivacaine 0.5% and ropivacaine 0.75%, in terms of their duration of anesthesia, duration of analgesia and their effect in controlling postoperative pain after surgical removal of impacted lower third molars. Material and Methods:This study was conducted on fifty subjects referred to the Oral Surgery Department, Faculty of Dentistry, Mansoura University, for surgical removal of impacted lower third molar. Subjects were randomly assigned prior to surgery into 2 nerve block injections; the first group (group A) for an inferior alveolar nerve block (IANB) using bupivacaine and the second group (group B) for an IANB using ropivacaine. In each group, the patient's age, sex, type of impaction, severity of impaction was recorded. Time from the start of surgery till removal of impacted molar was taken as duration of surgery. Patients were instructed not to take any analgesics until numbness of lip and tongue receded.The time from onset of anaesthesia to when numbness of the lip and tongue receded as assessed by pricking is taken as the duration of anaesthesia. The time from the start of numbness to when the subject first requested a dose of oral analgesic (NSAID) was taken as duration of analgesia. Pain was assessed preoperatively and postoperatively, then patients instructed to record the extent of their pain at 3, 6, 9, and 12 hours on the day of surgery (D1), on the second (D2) and third days (D3) postoperatively. Post-operative analgesic consumption, inability to sleep because of pain, degree of overall satisfaction with the anaesthetic efficacy and postoperative pain management were considered. Results:The median duration of anaesthesia for the 7.5 mg/ml concentration of ropivacaine was approximately 6 hours, and for bupivacaine 5 mg/ml was approximately 7 hours. Bupivacaine can provide analgesia for 10.3 hours while ropivacaine can provide analgesia during the first 9.6 hours which is the period of maximum pain after third molar surgery. Conclusion:As regards a comparison of the study drugs with respect to post-operative pain experience, analgesic need and consumption, bupivacaine and ropivacaine appear to have equivalent efficacy.

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“…For Query 2, nine articles [13][14][15][16][17][18][19][20][21] were returned initially and, after application of inclusion criteria, two articles [13,20] were included in the analysis. Femoral nerve blocks decreased the weighted mean knee arthroplasty pain from 4.7 (opioid group) to 2.0 cm (femoral nerve group) in the recovery room and on postoperative day #1 (Tables 3 and 4).…”

Section: Resultsmentioning

confidence: 99%

Comparing the Cumulative Pain Patients Experience Waiting for Knee Arthroplasty to their Postoperative Pain

Schwenk¹,

Dexter²,

Epstein³

2013

J Anesth Clin Res

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Introduction: Reduction of pain is a major goal of anesthesiologists treating patients undergoing knee arthroplasty. This has been achieved traditionally through the use of regional analgesia. Although these techniques decrease postoperative pain, they inherently do not affect the longstanding pain patients experience as they wait for surgery. Our objectives were to quantify: 1) the decrease in pain achieved by surgical joint replacement; and 2) the decrease in postoperative pain achievable through femoral nerve blocks versus opioids. From a systems-based perspective, we wanted to determine how much reduction in waiting time before surgery would be necessary to achieve an equal cumulative pain decrease (i.e, pain x duration of pain) as that afforded by regional techniques in the immediate postoperative period. Materials and methods:A systematic review using PubMed was performed to obtain: 1) articles reporting preoperative pain scores for patients awaiting joint arthroplasty; 2) articles with knee arthroplasty patients who received femoral nerve blocks; and 3) articles providing duration on joint arthroplasty waiting lists. Cumulative pain was assessed by the area under the response curve of pain scores vs. time, a methodology that is simple and valid. This was calculated by multiplying mean pain scores by the duration of pain. Results:The decrease in knee pain subsequent to arthroplasty (6.4/10 vs. 2.9/10) is similar to the decrease in pain afforded by femoral nerve blocks for knee arthroplasty (4.7/10 vs. 2.0/10). Waiting times in many countries exceed 3 months. A decrease in waiting time by about 2 days results in a decrease in the area under the curve of Conclusion: Reducing waiting time for knee arthroplasty decreases total pain experienced by patients and is one systems-based approach that anesthesiologists could take to relieve pain. Further studies are needed to evaluate how best to accomplish this goal.pain comparable to that afforded by femoral nerve blocks.

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The preemptive effect of single shot, the 3 in 1 femoral nerve block with ropivacaine 0.375% on postoperative morphine consumption in elderly patient after unilateral total knee replacement

Cited by 12 publications

References 0 publications

Single-injection femoral nerve block with 0.25% ropivacaine or 0.25% bupivacaine for postoperative analgesia after total knee replacement or anterior cruciate ligament reconstruction

Single-injection femoral nerve block with 0.25% ropivacaine or 0.25% bupivacaine for postoperative analgesia after total knee replacement or anterior cruciate ligament reconstruction

Ropivacaine versus Bupivacaine in Postoperative Pain Control

Comparing the Cumulative Pain Patients Experience Waiting for Knee Arthroplasty to their Postoperative Pain

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