The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial

Kampitak Wirinaree; Tanavalee Aree; Tansatit Tanvaa; Ngarmukos Srihatach; Songborassamee Nattaporn; Vichainarong Chutikant

doi:10.4097/kja.21120

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자료유형: 학술저널

저자정보: Kampitak Wirinaree (Chulalongkorn University) Tanavalee Aree (Chulalongkorn University) Tansatit Tanvaa (Chulalongkorn University) Ngarmukos Srihatach (Chulalongkorn University) Songborassamee Nattaporn (Chulalongkorn University) Vichainarong Chutikant (Chulalongkorn University)

저널정보: 대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.74 No.6

발행연도: 2021.12

수록면: 496 - 505 (10page)

DOI: 10.4097/kja.21120

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Background: Ultrasound-guided femoral triangle block (FTB) can provide motor-sparing anterior knee analgesia. However, it may not completely anesthetize the anterior femoral cutaneous nerve (AFCN). We hypothesized that an AFCN block (AFCNB) in combination with an FTB would decrease pain during movement in the immediate 12 h postoperative period compared with an FTB alone.Methods: Eighty patients scheduled to undergo total knee arthroplasty were randomized to receive either FTB alone (FTB group) or AFCNB with FTB (AFCNB + FTB group) as part of the multimodal analgesic regimen. The primary outcome was pain during movement at 12 h postoperatively. Secondary outcomes included numeric rating scale (NRS) pain scores, incidence of surgical incision site pain, intravenous morphine consumption, immediate functional performance, patient satisfaction, and length of hospital stay.Results: The NRS pain scores on movement 12 h postoperatively were significantly lower in the AFCNB + FTB group than in the FTB group (mean difference: ?2.02, 95% CI: ?3.14, ?0.89, P < 0.001). The incidence of pain at the surgical incision site at 24 h postoperatively and morphine consumption within 48 h postoperatively were significantly lower (P < 0.001), and quadriceps muscle strength at 0° immediately after surgery was significantly greater in the AFCNB + FTB group (P = 0.04).Conclusions: The addition of ultrasound-guided AFCNB to FTB provided more effective analgesia and decreased opioid requirement compared to FTB alone after total knee arthroplasty and may enhance immediate functional performance on the day of surgery.

#Arthroplasty #Knee #Nerve block #Peripheral nerves #Postoperative pain #Ultrasonography.

참고문헌 (30)

참고문헌 신청

Oseka L / 2018 / Anesthetic management in early recovery after surgery protocols for total knee and total hip arthroplasty / AANA J 86:32~39

Ellis TA 2nd / 2018 / Multimodal clinical pathway with adductor canal block decreases hospital length of stay, improves pain control, and reduces opioid consumption in total knee arthroplasty patients : a retrospective review / J Arthroplasty 33:2440~2448

Li D / 2016 / Analgesic efficacy and quadriceps strength of adductor canal block versus femoral nerve block following total knee arthroplasty / Knee Surg Sports Traumatol Arthrosc 24:2614~2619

Abdallah FW / 2016 / Adductor canal block provides noninferior analgesia and superior quadriceps strength compared with femoral nerve block in anterior cruciate ligament reconstruction / Anesthesiology 124:1053~1064

Brandon Kandarian / 2019 / Implementation of the IPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) block into a multimodal analgesic pathway for total knee replacement / Korean Journal of Anesthesiology 72(3):238~244

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