Abstract:
ABSTRACT
Background
Total knee arthroplasty is among the advanced orthopaedic surgical procedures and the trend
of this intervention has been increasing over the last 2 to 3 decades worldwide. The major
indication for total knee arthroplasty is osteoarthritis. Although the trend is growing up, the
major challenge is on controlling postoperative pain. Total Knee Arthroplasty is regarded as
among the painful procedure for up to 72hours postoperatively. In different parts of the world,
femoral nerve block has been shown to improve pain management, especially when used in
the multimodal approach in TKA patients. In our setting, no study has been done to evaluate
the benefits of femoral nerve block versus conventional systemic opioids in the management
of pain in patients post Total Knee Arthroplasty
Objective
To determine the outcome of femoral nerve block for postoperative analgesia in patients
undergoing TKA at MOI
Materials and Methods
This was a hospital-based prospective randomized comparative study. The study population
constituted 72 adult patients between 18 and 85yrs of age, who underwent TKA. Patients were
randomized into two groups, each group having 36patients. During surgery, all patients
received standard general anaesthesia.
In the post-anaesthesia care unit, one group received single-shot femoral nerve block with
30ml of 0.25% Bupivacaine under ultrasound guidance and the other group received
conventional systemic opioids for pain management. One patient was drop out in femoral
nerve block due to failure of the block.
Diclofenac 75mg was given to all patients as per schedule for preemptive analgesia. Pethidine
100mg 6hrly was given intramuscularly to the non-femoral block group. Also, pethidine given
to patients receives femoral nerve block group once they started to complain pain NRS of> 4.
Data were collected from the written questionnaire transferred and analyzed with SPSS
computer program version 20.0. The continuous variables were presented as mean, standard
xi
deviation and categorical variables presented as a percentage. Associations were tested via
Chi-square for categorical variables and t-test for continuous variables. A 95% confidence
interval and P-value of 0.05 was used for statistical significance.
