In people with knee replacement, genicular nerves block can be used as an alternative to local infiltration analgesia since both are comparable in terms of analgesic results, according to a study published in The European Journal of Anaesthesiology. Investigators undertook this prospective noninferiority cohort study to assess the noninferiority of the pain-relieving effect of genicular nerves block compared with local infiltration analgesia following 24 hours of knee replacement.

The study prospectively included 35 participants scheduled for knee arthroplasty and were compared with 35 participants in the retrospective cohort. Ultrasound-guided genicular nerve block in the prospective arm was comparatively evaluated with local infiltration analgesia in the retrospective arm. The major endpoints were the pain numeric rating scale (NRS) and cumulative intake of opioids in oral morphine equivalents during the initial 24 hours.

Propensity score-matched analyses of participants were carried out utilizing acute postsurgery pain-associated risk covariates. Following one-to-one propensity score matching, participants were divided into either local infiltration analgesia group (n=21) or genicular nerve block group (n=21).

The median difference in cumulative opioid intake was 4.99 mg for the matched group and 2.5 mg for the unmatched cohort (meeting the noninferiority criteria, Δ = 21 mg), while the median difference in NRS at rest at 24 hours was -1.9 for the matched cohort and -0.99 for the unmatched cohort. Thus, both genicular nerve block and local infiltration analgesia are comparable in terms of pain improvement.