Continuous femoral nerve block versus patient-controlled analgesia following total knee arthroplasty

J Orthop Surg (Hong Kong). 2012 Apr;20(1):23-6. doi: 10.1177/230949901202000105.

Abstract

Purpose: To compare total knee arthroplasty (TKA) patients who received continuous femoral nerve block (FNB) with local anaesthetics through a catheter versus patient-controlled analgesia (PCA) with intravenous morphine.

Methods: 50 women and 10 men aged 51 to 84 years with matched characteristics underwent TKA and received either continuous FNB with local anaesthetics through a catheter (n=30) or PCA with intravenous morphine (n=30). None of the patients had had previous knee surgery. All operations were performed according to the standard protocol. Daily mean pain numerical rating scale at rest (NRS-R) and during movement (NRS-M), requirement of extra pain control, complications related to pain control, and overall patient satisfaction in both groups were compared.

Results: Both groups were similar in terms of pain NRS-R and NRS-M, overall satisfaction, and length of hospital stay. Within each group, pain NRS-M score was significantly higher than pain NRS-R score. In the FNB group, 3 patients had dislodgement of the femoral catheter on day 1 and switched to PCA with intravenous morphine. Two of them had fair satisfaction. Patients in the PCA group had significantly more side-effects (nausea, vomiting, dizziness, and pruritis); 2 of the 5 patients with nausea and vomiting had fair satisfaction. No patients had any surgical complication.

Conclusion: Both FNC and PCA provide reliable pain control.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesia, Patient-Controlled*
  • Arthroplasty, Replacement, Knee*
  • Female
  • Femoral Nerve*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / prevention & control*