Multimodal Periarticular Injection Vs Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Prospective, Crossover, Randomized Clinical Trial
Section snippets
Patients and Methods
This was a prospective, patient- and assessor-blinded, placebo-controlled, crossover randomized clinical trial. This study was approved by the institutional review board. Chinese patients scheduled for staged TKA for osteoarthritis were recruited. The staged operations were performed at a minimum interval of 3 months. Excluded from the study were patients with known allergies to any of the test drugs, those with major systemic illnesses (heart failure, renal impairment, and coagulopathy),
Results
From December 2008 to March 2010, 18 patients (15 females and 3 males) were recruited. One patient, who was randomized to the MPI group in the first-stage operation, refused the second-stage operation because of a spinal problem. Another patient who was randomized to the FNB group in the first-stage operation had a patella fracture 3 months after the operation because of an accidental fall. The results of the remaining 16 patients (14 females and 2 males) were analyzed. Patient demographics and
Discussion
In the last decade, one of the greatest advances in total joint arthroplasty is perioperative pain management [8]. Wound pain after TKA is usually graded as moderate to severe. Patients often fear the postoperative pain more than the risks of the surgery itself. According to the International Association for the Study of Pain, pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” [9]. Pain is
References (22)
- et al.
Patient-controlled analgesia in a postoperative total joint arthroplasty population
J Arthroplasty
(1991) - et al.
Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty
J Arthroplasty
(2001) - et al.
Serum and wound drain ropivacaine concentrations after wound infiltration in joint arthroplasty
J Arthroplasty
(2007) - et al.
Multimodal analgesia without parenteral narcotics for total knee arthroplasty
J Arthroplasty
(2008) - et al.
The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty
J Arthroplasty
(2006) - et al.
Postoperative analgesia: economics, resource use, and patient satisfaction in an urban teaching hospital
Anesth Analg
(2002) - et al.
Femoral nerve block. Single injection versus continuous infusion for total knee arthroplasty
Reg Anesth
(1996) - et al.
Peripheral nerve blocks improve analgesia after total knee replacement surgery
Anesth Analg
(1998) - et al.
A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study
J Bone Joint Surg [Am]
(2006) - et al.
Efficacy of periarticular multimodal drug injection in total knee arthroplasty. A randomized trial
J Bone Joint Surg [Am]
(2006)
Multimodal pain management after total hip and knee arthroplasty at the Ranawat Orthopaedic Center
Clin Orthop Relat Res
Cited by (0)
The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.12.021.