Comparison of continuous femoral nerve block and continuous intraarticular block for pain control and recovery of knee function after total knee arthroplasty

Abstract

Objective. Wecompared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and side effects after total knee arthroplasty (TKA). Methods. 54 patients undergoing TKA were prospectively randomized into two groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anaesthesia. All patients received patient - controlled analgesia (PCA) with morphine, diclofenac and acetaminophen for the first 72 h postoperatively. Pain was assessed with a visual analog scale (VAS), 48 h morphine consumption and 72 h local anaesthetic dosage were recorded, motor blockade was assessed, maximum range of motion (ROM) was measured and side effect profiles were recorded. Results. There was no significant difference in postoperative pain at rest, in passive motion, active motion and active movement (2-min walk test (2MWT)) between study groups. Group I had less opioid usage in the first 24 h postoperatively (p<0.05). Significantly lower scores of Bromage scale in Group I in 72 h after surgery (p<0.05) were found. Group I had better passive maximum ROM in 1 month after surgery and superior active maximum ROM on day 7 and 1 month after surgery. [...].