Ultrasound-Guided Motor-Sparing Knee Blocks showed good results for Postoperative Analgesia succeeding Total Knee Arthroplasty

Primary tabs

NEWS
Ultrasound-Guided Motor-Sparing Knee Blocks showed good results for Postoperative Analgesia succeeding Total Knee Arthroplasty

Knee arthroplasty is surgery for people with severe knee damage. Knee arthroplasty can relieve pain and allow you to be more active. Pain following total knee arthroplasty (TKA) is serious and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they conserve motor strength and permit early mobilization. The primary aim was to differentiate the duration of analgesia from motor-sparing blocks with that of a standard periarticular infiltration. It was used the time to first rescue analgesia as the endpoint.

The study was randomized 82 patients scheduled for elective TKA. Patients received either the preoperative motor-sparing block (0.5% ropivacaine, 10 mg of morphine, 2.5 μg/mL of epinephrine, and 30 mg of ketorolac) or intraoperative periarticular infiltration (0.3% ropivacaine, 10 mg of morphine, 2.5 μg/mL of epinephrine, and 30 mg of ketorolac). Reform the ultrasound-guided adductor canal block by collaborating it with a lateral femoral cutaneous nerve block and posterior knee infiltration for the motor-sparing block. The patients, surgeons, anaesthetists control the blocks, and outcome reviewer all remained blinded to group allocation. The main conclusion was the duration of analgesia (time to first rescue analgesia). Secondary outcomes included quadriceps strength, function, side effects, satisfaction, and length of hospital stay.

The duration of analgesia was consequently prolonged (mean differentiation, 8.8 hours [95% confidence interval = 3.98 to 13.62], p < 0.01) for the motor-sparing-block section (mean [and standard deviation], 18.1 ± 1.7 hours) differentiate with the periarticular infiltration group (mean, 9.25 ± 1.7 hours). The infiltration group had consequently higher scores for pain at rest for the first two postoperative hours and pain with knee movement at 2 and 4 hours. There were no significant differences between groups about any other secondary outcomes. Undergoing a TKA, patients had a motor-sparing block produce longer analgesia than periarticular infiltration with retention of quadriceps muscle strength, patient satisfaction, function, and a short hospital stay.

Source:

J Bone Joint Surg Am. 2017 Aug

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28763413

Original title of the article:

Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study.

Authors:

Sogbein O. A.; et al.

SearchTags: 
Diagnostic, Knee arthroplasty, Knee, Severe, Analgesic, Ultrasound-guided
Log in or register to post comments