Continuous femoral nerve blockade and single-shot sciatic nerve block promotes better analgesia and lower bleeding for total knee arthroplasty compared to intrathecal morphine: a randomized trial

BMC Anesthesiology
Nora Elizabeth Rojas ÁlvarezJoaquim Edson Vieira

Abstract

Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group). Pain score from verbal numeric rating scale (VNRS) and morphine consumption during the first 72 h, as well as motor blockade, adverse effects, and postoperative bleeding were recorded. Analysis of variance of repeated measures with Bonferroni post-test, t-test and Fisher exact test were used for statistical analysis. Thirty nine patients completed the study (M = 20; FI = 19 patients) and were similar except for higher age in the FI group. Motor blockade as well as movement pain during postanesthesia care unit (PACU) staying were not different between the groups, but movement pain was significantly lower in FI grou...Continue Reading

Associated Clinical Trials

References

Jul 1, 1975·Anesthesia and Analgesia·P P RajM T Jenkins
Apr 25, 2009·Acta Anaesthesiologica Scandinavica·L KadicJ J Driessen
Jul 17, 2012·Journal of Opioid Management·Borja Mugabure BujedoAmaia Uría Azpiazu
May 16, 2014·The Cochrane Database of Systematic Reviews·Ee-Yuee ChanNelson Chua
Aug 12, 2014·Current Opinion in Anaesthesiology·Martin C R BauerPeter K Zahn
Apr 22, 2015·The Journal of Knee Surgery·Randa K ElmallahMichael A Mont
Apr 25, 2015·Revista da Associação Médica Brasileira·Lúcio Honório de Carvalho JúniorMatheus Braga Jacques Gonçalves
Jan 6, 2016·The Cochrane Database of Systematic Reviews·Joanne Guay, Sandra Kopp
Feb 21, 2016·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Faraj W AbdallahRichard Brull

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