Key result
Continuous femoral nerve block provided inferior pain relief compared to epidural analgesia at 6 and 12 hours after unilateral total knee replacement, with higher pain scores.
Why the study?
Identifying the most effective and safe approach to postoperative pain management can enhance patient recovery, improve quality of life, and optimize healthcare resource utilization.
Does continuous femoral nerve block compared to epidural analgesia improve postoperative pain relief in patients undergoing unilateral total knee replacement?
RCT (n=60)
Consecutive random sampling
No
Does continuous femoral nerve block compared to epidural analgesia improve postoperative pain relief in patients undergoing unilateral total knee replacement?
Epidural analgesia provides superior early postoperative pain relief (at 6 and 12 hours) compared to continuous femoral nerve block after unilateral total knee replacement.
Answers are grounded in this paper and cite their sources.
Favors epidural over continuous femoral nerve block for early post-TKA analgesia; confirms superiority in RCT evidence.
Background: By identifying the most effective and safe approach to postoperative pain management, we can enhance patient recovery, improve their quality of life, and optimize healthcare resource utilization. Objective: Comparison of the Efficacy of Continuous Femoral Nerve Block with Epidural Analgesia for Postoperative Pain Relief after Unilateral Total Knee Rep. Method: The study was conducted as a randomized controlled trial at Tertiary Hospital in Dhaka. Sixty patients, consisting of 12 males and 48 females, between the ages of 40 and 90 years, were enrolled in the study. These patients were scheduled to undergo unilateral total knee replacement (TKR) for osteoarthritis and fell under American Society of Anesthesiologists (ASA) physical status classes I and II. The inclusion criteria required patients to weigh between 50 and 99 kg and have the ability to fully understand and respond to the numeric rating scale (NRS). Exclusion criteria comprised patients with ASA physical status class ≥3, those on chronic opiate therapy, individuals with allergies to local anesthetics or equipment materials, or those with neuromuscular disease. Ethical approval was obtained, and the patients were divided into two groups: group A received epidural analgesia, while group B received a femoral nerve block for postoperative pain management. Pain assessments were conducted using the NRS at six, 12, and 24 hours postoperatively, and data were collected for analysis. Results: During the study, in group A (Epidural) and Group B (Femoral nerve block) mean age was 69.45 ± 7.34 and 65.45 ± 7.34 years. Mean Preoperative knee extension between two groups was Group A (Epidural): 9.05 ± 4.38 and Group B (Femoral nerve block): 7.76 ± 4.14. The results showed a significant difference for NRS scoring at six hours and 12 hours. Patients who were in group A and were given Epidural postop for pain management showed better results and lower values for NRS and needed fewer extra boluses for their .....
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Baki et al. (2023) conducted an RCT in Unilateral total knee replacement for osteoarthritis (n=60). Continuous femoral nerve block vs. Epidural analgesia was evaluated on Numeric Rating Scale (NRS) score at 6 hours postoperatively (mean rank) (p=<0.001). Continuous femoral nerve block provided inferior pain relief compared to epidural analgesia at 6 and 12 hours after unilateral total knee replacement, with higher pain scores.
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