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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.
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