Comparison of ultrasound-guided femoral + anterior sciatic nerve block and genicular nerve block for postoperative pain in total knee arthroplasty
Purpose: This study aimed to compare the effectiveness of ultrasound-guided femoral and anterior sciatic (FAS) nerve blocks and genicular (G) nerve blocks as preventive analgesia methods after total knee arthroplasty. Materials and Methods: Fifty patients, aged 55–80 years were divided into two grou...
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Veröffentlicht in: | Cukurova Medical Journal 2021-12, Vol.46 (4), p.1433-1440 |
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Zusammenfassung: | Purpose: This study aimed to compare the effectiveness of ultrasound-guided femoral and anterior sciatic (FAS) nerve blocks and genicular (G) nerve blocks as preventive analgesia methods after total knee arthroplasty.
Materials and Methods: Fifty patients, aged 55–80 years were divided into two groups preoperatively. Patients in the FAS group (n=25) received 20 mL solutions (10 mL 0.5% bupivacaine, 1 mL [4 mg] dexamethasone, and 9 mL saline) in both femoral and sciatic blocks. Patients in the G group (n=25) received 5 mL solutions (2 mL 0.5% bupivacaine, 1 mL [4 mg] dexamethasone, and 2 mL saline) for each nerve. Patients were assessed 24 h postoperatively, and pain scores, time to first analgesic requirement, total analgesic dose, and postoperative complications during the first 24 h were recorded.
Results: VAS scores at postoperative 0, 1, and 6 h and the total amount of tramadol consumed 24 h were lower in the FAS group than in the G group. There was no requirement for additional analgesia in the first 24 h in the FAS group; however, 9 patients required additional analgesia in the G group.
Conclusion: USG FAS nerve blocks were superior to the genicular nerve blocks in TKA. Additionally, the genicular block doesn’t cause motor block. A genicular block can be considered as an alternative with this regard.
Amaç: Çalışmamızın amacı; genel anestezi altında yapılan total diz artroplastisinde (TDA) ultrason eşliğinde uygulanan femoral ve anterior siyatik (FAS) sinir bloğu ile geniküler (G) sinir bloğunun postoperatif analjezik etkilerini araştırmaktır.
Gereç ve Yöntem: Ameliyat öncesi 55-80 yaş arası toplam 50 hasta 2 gruba ayrıldı. FAS gruptaki hastalara (n=25) 20 ml solüsyon (10 ml %0.5 Bupivakain+1 ml (4 mg) Deksametazon+ 9 ml serum fizyolojik) ultrason eşliğinde hem femoral hem de siyatik blok uygulamak için uygulandı. G gruptaki hastalara (n=25) her bir geniküler sinire 5 ml solüsyon (2 ml %0.5 Bupivakain+ 1 ml (4 mg) Deksametazon+ 2 ml serum fizyolojik) geniküler blok için ultrason eşliğinde uygulandı. Hastaların postoperatif 24 saat boyunca ağrı skorları, tüketilen opioid miktarları, ilk analjezik gereksinim zamanları, postoperatif komplikasyonları kaydedildi.
Bulgular: Postoperatif 0, 1, ve 6. saatteki VAS skorları ve postoperatif 24 saat boyunca tüketilen tramadol miktarı FAS grubunda G grubuna göre anlamlı olarak daha düşük bulundu. Operasyon sonrası FAS grupta hiç ek analjezik gereksinimi olmazken, G grubunda 9 hastada ek analjezik ihtiyacı oldu.
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ISSN: | 2602-3032 2602-3040 |
DOI: | 10.17826/cumj.977400 |