effect of a single shot sciatic nerve block combined with a continuous femoral block on pain scores after knee arthroplasty. a randomized controlled trial一枪的坐骨神经阻滞结合连续股块膝关节置换术后疼痛分数。.pdfVIP

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effect of a single shot sciatic nerve block combined with a continuous femoral block on pain scores after knee arthroplasty. a randomized controlled trial一枪的坐骨神经阻滞结合连续股块膝关节置换术后疼痛分数。.pdf

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effect of a single shot sciatic nerve block combined with a continuous femoral block on pain scores after knee arthroplasty. a randomized controlled trial一枪的坐骨神经阻滞结合连续股块膝关节置换术后疼痛分数。

Open Journal of Anesthesiology, 2012, 2, 107-112 107 /10.4236/ojanes.2012.24025 Published Online September 2012 (http://www.SciRP.org/journal/ojanes) Effect of a Single Shot Sciatic Nerve Block Combined with a Continuous Femoral Block on Pain Scores after Knee Arthroplasty. A Randomized Controlled Trial 1,2 1 1 Raul Carvalho , Luisa Calixto , Jose Pedro Braganca 1Serviço de Anestesia, Centro Hospitalar do Porto, Porto, Portugal; 2Departamento de Ciências da Informação e da Decisão em Saúde, Faculdade de Medicina, Universidade do Porto, Porto, Portugal. Email: raul@meo.pt Received July 3rd, 2012; revised August 4th, 2012; accepted August 22nd, 2012 ABSTRACT Background and Purpose: Perioperative pain after total knee arthroplasty (TKA) is reported as severe in up to 60% of patients. Continuous femoral nerve blocks (CFNB) are a choice for major knee repair, but controversies remain about the need of supplemental sciatic nerve blocks (SNB) for better analgesia. Our aim is to assess the effect of the associa- tion of a SNB to a CFNB to reduce postoperative pain after TKA. Methods: A prospective randomized, single blinded, controlled study, on 50 patients undergoing TKA. Control group received a CFNB before general anesthesia; in the in- tervention group a single shot SNB was added after the CFNB was done. After the end of surgery all patients started a continuous local anesthetic infusion through the femoral catheter in the PACU (post-anesthesia care unit). Pain scores were measured in the PACU and at 12 h and 24 h postoperative using a visual analog scale (VAS). Results: VAS pain scores (mm) were lower and statistically significant for the intervention group up to 12 h postoperative: PACU admis- sion mean VAS = 59.4 vs 30.2, P = 0.001; at 12 h mean VA