A Comparison of the Results from Femoral Nerve Block Using Different Concentration of Ropivacaine after Total Knee Arthroplasty

Jung-Wook Huh; Man-Jun Park; Young-Chul Ko; Dong-Jun Ha; Sook-Hyun Park; Tae-Hong Park; Joon-Hyung Park

A Comparison of the Results from Femoral Nerve Block Using Different Concentration of Ropivacaine after Total Knee Arthroplasty

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슬관절 인공관절 치환술 후 대퇴신경 차단술의 Ropivacaine 농도 변화에 따른 결과 비교

Type: Academic journal

Author: Jung-Wook Huh (부산의료원) Man-Jun Park (부산의료원) Young-Chul Ko (부산의료원) Dong-Jun Ha (부산의료원) Sook-Hyun Park (부산의료원) Tae-Hong Park (부산의료원) Joon-Hyung Park (부산의료원)

Journal: THE KOREAN ORTHOPAEDIC ASSOCIATION JOURNAL OF THE KOREAN ORTHOPAEDIC ASSOCIATION Vol.53 No.3 KCI Accredited Journals

Published: 2018.6

Pages: 243 - 247 (5page)

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A Comparison of the Results from Femoral Nerve Block Using Different Concentration of Ropivacaine after Total Knee Arthroplasty

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Purpose: Peripheral nerve block is one of the many options available to reduce pain after total knee arthroplasty. Among the various kinds of peripheral nerve block procedure, femoral nerve block (FNB) using ropivacaine is a very effective method for reducing pain. However, it has been known to cause weakness in the quadriceps femoris, resulting in an increased risk of fall during ambulation after surgery. The purpose of this study was to compare the effectiveness of FNB on pain and muscle strength with different concentrations of ropivacaine.
Materials and Methods: Our study was performed on 120 patients with knee osteoarthritis who had undergone total knee arthroplasty between January 2016 and December 2016. Patients were divided to 3 groups depending on the concentration of ropivacaine: Group 1 received 0.125% ropivacaine 6 ml FNB; group 2 received 0.2% ropivacaine 6 ml FNB; group 3 received normal saline 6 ml FNB. FNB with 1% lidocaine 10 ml and 0.75% ropivacaine 10 ml was performed to all groups at 3 hours after surgery. From the day after surgery, each group of patients were injected 4 times with FNB on their own designated concentration of ropivacaine with an interval of 6 hours. The severity of pain was estimated by visual analogue scale (VAS) and the strength of quadriceps femoris was measured using medical research council (MRC) grade and knee extension angle.
Results: VAS score in group 3 was significantly higher compared to other groups; MRC grade in group 2 was significantly lower than in other grades, and knee extension angle in group 2 was significantly lower than in other groups at 6 pm on the day of and at 6 am on the day after surgery. VAS score, MRC grade, and extension angle of all groups showed no significantly difference at other times.
Conclusion: FNB with 0.125% ropivacaine after total knee arthroplasty shows effective reduction of pain without inducing quadriceps femoris weakness.

#total knee arthroplasty #femoral nerve block #0.125% ropivacaine #quadriceps femoris power #슬관절 인공관절 치환술 #대퇴신경 차단술 #0.125% r opivacaine #대퇴사두근력

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