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COMPARISON OF THE ANALGESIC EFFECT POSTOPERATIVE TOTAL KNEE REPLACEMENT OF LOCAL INFILTRATION ANESTHESIA AND ULTRASOUND-GUIDED FEMORAL NERVE BLOCK
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Abstract
Objective: comparison of the analgesic effect postoperative total knee replacement (TKA) of local infiltration anesthesia (LIA) and ultrasound-guided femoral nerve block (FNB). Subject and methods: A randomized comparative trial, 60 patients undergoing TKA under laryngeal mask anesthesia were randomized to receive local infiltration analgesia (group LIA) 100 ml ropivacaine 0.2% or ultrasound-guided femoral nerve block (group FNB). The outcomes were morphine consumption, pain intensity at rest and upon movement was assessed on a visual analogue scale (VAS) (0–10), the range of motion, quadriceps muscle strength was assessed by manual muscle test (MMT) at 24h, 48h and 72h. Results: Total morphin consumption in group LIA was lower than that of group FNB (Day 1: 15,87 vs 19,3mg, day 2: 21,97 vs 25,8mg, day 3: 24,63 vs 25,67mg, p>0,05). The VAS score at rest and upon movement in group LIA was also lower than group FNB (at rest: day 1: 2,37 vs 2,9, day 2: 3,27 vs 3,67, day 3: 3,2 vs 3,23; upon movement: day 1: 3,43 vs 3,67, day 2: 4,33 vs 4,53, day 3: 5 vs 5,05, p>0,05). MMT scores in group LIA was significantly higher than group FNB hơn rõ rệt nhóm FNB (day 1: 3,84 vs 2,89, day 2: 3,99 vs 3,01, day 3: 4,24 vs 3,21, p<0,05). No different between groups were seen regarding range of motion. Conclusion: LIA is an effective pain reliever, equivalent to FNB for TKR. LIA improved postoperative rehabilitation better than FNB with statistically significant less effect on quadriceps muscle.
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Keywords
Local Infiltration Anesthesia; Analgesia; Morphine; Femoral Nerve Block.
References
2. Hishiyama S, Ishiyama T, Asano N, Kotoda M, Ikemoto K và cộng sự (2014). [Femoral nerve block for total knee arthroplasty]. Masui, 63(8),872-876.
3. Gao F, Ma J, Sun W, Guo W, Li Z, Wang W. Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. Clin J Pain. 2017;33(4), 356-368. doi:10.1097/AJP.0000000000000402
4. Affas F. Local infiltration analgesia in knee and hip arthroplasty efficacy and safety. Scand J Pain. 2016;13:59-66. doi:10.1016/j.sjpain.2016.05.041
5. Fan L, Yu X, Zan P, Liu J, Ji T, Li G. Comparison of Local Infiltration Analgesia With Femoral Nerve Block for Total Knee Arthroplasty: A Prospective, Randomized Clinical Trial. J Arthroplasty. 2016;31(6):1361-1365. doi:10.1016/j.arth.2015.12.028
6. Moghtadaei, Farahini, Hamid và cộng sự (2014). Pain Management for Total Knee Arthroplasty: Single-Injection Femoral Nerve Block versus Local Infiltration Analgesia. Iranian Red Crescent Medical Journal, 16(1), e13247.
7. Chaumeron và cộng sự (2013). Periarticular Injection in Knee Arthroplasty Improves Quadriceps Function. Clinical Orthopaedics and related Research, 471 (7), 2284-2295.
8. Affas, Nygårds, Stiller và cộng sự (2011). Pain control after total knee arthroplasty: a randomized trial comparing local infiltration anesthesia and continuous femoral block. Acta Orthopaedica, 82 (3), 441–447.
9. M Chandrashekaraiah, H Shah, Adeel và cộng sự (2021). Impact of intra-articular local anesthesia infiltration versus femoral nerve block for postoperative pain management in total knee arthroplasty. Anesthesia, Essays and Researches, 15(2), 208-212.
10. Ashraf, V Raut, J Canty và cộng sự (2013). Pain control after primary total knee replacement. A prospective randomized controlled trial of local infiltration versus single shot femoral nerve block. The Knee, 20(5), 324-327.