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Tytuł:
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Postoperative analgesia for total knee replacement: comparing between pre-and postoperative "3-in-1" femoral nerve block.
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Autorzy:
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Bunburaphong P; Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. />Niruthisard S
Werawatganon T
Keeyapaj W
Vimuktanandana A
Toleb K
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Źródło:
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Journal of the Medical Association of Thailand = Chotmaihet thangphaet [J Med Assoc Thai] 2006 Apr; Vol. 89 (4), pp. 462-7.
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Typ publikacji:
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Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Bangkok : Medical Association Of Thailand
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MeSH Terms:
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Nerve Block*
Analgesics, Opioid/*therapeutic use
Anesthetics, Local/*therapeutic use
Arthroplasty, Replacement, Knee/*adverse effects
Bupivacaine/*therapeutic use
Femoral Nerve/*drug effects
Morphine/*therapeutic use
Pain, Postoperative/*drug therapy
Aged ; Anesthetics, Local/administration & dosage ; Bupivacaine/administration & dosage ; Female ; Humans ; Injections ; Male ; Postoperative Care ; Preoperative Care ; Time Factors
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Substance Nomenclature:
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0 (Analgesics, Opioid)
0 (Anesthetics, Local)
76I7G6D29C (Morphine)
Y8335394RO (Bupivacaine)
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Entry Date(s):
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Date Created: 20060516 Date Completed: 20060614 Latest Revision: 20131121
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Update Code:
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20240104
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PMID:
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16696391
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Background: Total Knee Replacement (TKR) produces severe postoperative pain. Pre- and postoperative single-shot "3-in-1" Femoral Nerve Block (FNB) were reported to improve analgesia and reduce morphine consumption post TKR.
Objective: To find out the most beneficial time for injection of single shot "3-in-1" FNB for TKR between preoperative and postoperative in a prospective controlled trial.
Material and Method: In a Randomized, double-blind Controlled Trial (RCT), 48 patients undergoing TKR received either pre- or postoperative "3-in-1" FNB using 30 mL of bupivacaine 0.25% after a standardized general anesthesia. Morphine consumption, Numeric Pain-Rating Scale (NPRS) at rest and during movement, tension in the back of the knee, nausea/vomiting, pruritus, sedation, and respiratory depression at 1, 4, 24 and 48 hr after TKR were compared
Results: There were no significant differences in 48-hr morphine consumption [46.5 (20.0) vs 45.0 (23.6) mg, p = 0.809], NPRS both at rest and during movement, tension in the back of knee, nausea/vomiting, pruritus, sedation, and respiratory depression at any time during 48-hr postoperative TKR between groups.
Conclusion: Preoperative single-shot "3-in-1" FNB using 30 mL of bupivacaine 0.25% is not better than postoperative single-shot "3-in-1" FNB using the same drug in postoperative pain and morphine reduction in patients undergoing elective TKR under general anesthesia.
