Analgesic effect of femoral and sciatic nerve block under multimodal analgesia in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2017.19.003

Abstract

Abstract:

BACKGROUND: The effectiveness of femoral nerve block in perioperative analgesia for total knee arthroplasty has been widely recognized, but the need for combined sciatic nerve block remains controversial.

OBJECTIVE: To investigate the analgesic effect and rehabilitation training of femoral and sciatic nerve block in the perioperative period of total knee arthroplasty.

METHODS: 150 patients undergoing total knee arthroplasty were randomly divided into three groups: general anesthesia, femoral nerve block and femoral and sciatic nerve block groups. The visual analogue scale scores at rest and in activity, range of motion of the knee, postoperative hospitalization time, adverse effects and the Hospital for Special Surgery scores were recorded and compared among groups.

RESULTS AND CONCLUSION: (1) The order of visual analogue scale scores at rest and in activity at each time point postoperatively was as follows: general anesthesia group > femoral nerve block group > femoral and sciatic nerve block group (P < 0.05). (2) The range of motion of the knee at different time points postoperatively was largest in the femoral nerve block group, followed by the femoral nerve block group, and smallest in the general anesthesia group (P < 0.05). (3) The postoperative hospitalization time in the femoral nerve block and femoral and sciatic nerve block groups was significantly less than that in the general anesthesia group, and the time in the femoral and sciatic nerve block group was significantly less than that in the femoral nerve block group (P < 0.05). (4) The Hospital for Special Surgery scores at 1 month postoperatively in the femoral nerve block and femoral and sciatic nerve block groups were significantly higher than those in the general anesthesia group, and the scores in the femoral and sciatic nerve block group were significantly higher than those in the femoral nerve block group (P < 0.05). But the Hospital for Special Surgery knee scores at 3 and 6 months postoperatively did not differ significantly among groups (P > 0.05). (5) These results indicate that the femoral and sciatic nerve block has better postoperative analgesia effect compared with general anesthesia and femoral nerve block under multimodal analgesia in total knee arthroplasty, which is favorable for early rehabilitative training.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Osteoarthritis, Knee, Arthroplasty, Replacement, Knee, Analgesia, Tissue Engineering

CLC Number:

R318

Gao Wei-lu, Li Hong, Liu Bi-quan, Hu Yong, Liu Jing-jun, Yin Li, Liu Hu, Mei Bin, Yin Zong-sheng. Analgesic effect of femoral and sciatic nerve block under multimodal analgesia in total knee arthroplasty

[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(19): 2966-2972.

Figures/Tables 2

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