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Local infiltration of analgesia and sciatic nerve block provide similar pain relief after total knee arthroplasty.
Tanikawa, Hidenori; Harato, Kengo; Ogawa, Ryo; Sato, Tomoyuki; Kobayashi, Shu; Nomoto, So; Niki, Yasuo; Okuma, Kazunari.
Afiliación
  • Tanikawa H; Department of Orthopaedic Surgery, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi, Yokohama, Kanagawa, Japan. adriatic123sea@gmail.com.
  • Harato K; Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjyuku, Tokyo, Japan.
  • Ogawa R; Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital, Minato-ku, Tokyo, Japan.
  • Sato T; Department of Anesthesiology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, Japan.
  • Kobayashi S; Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjyuku, Tokyo, Japan.
  • Nomoto S; Department of Orthopaedic Surgery, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi, Yokohama, Kanagawa, Japan.
  • Niki Y; Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjyuku, Tokyo, Japan.
  • Okuma K; Department of Orthopaedic Surgery, Saitama City Hospital, Saitama-shi, Saitama, Japan.
J Orthop Surg Res ; 12(1): 109, 2017 Jul 11.
Article en En | MEDLINE | ID: mdl-28697780
BACKGROUND: Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). METHODS: Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA. The outcome measures included post-operative pain, passive knee motion, C-reactive protein level, time to achieve rehabilitation goals, the Knee Society Score at the time of discharge, patient satisfaction level with anesthesia, length of hospital stay, surgical time, and complications related to local anesthesia. RESULTS: The patients in group SNB showed less pain than group LIA only on postoperative hours 0 and 3. Satisfactory postoperative analgesia after TKA was also achieved with LIA combined with FNB, while averting the risks associated with SNB. The influence on progress of rehabilitation and length of hospital stay was similar for both anesthesia techniques. CONCLUSIONS: The LIA offers a potentially safer alternative to SNB as an adjunct to FNB, particularly for patients who have risk factors for sciatic nerve injury.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Artroplastia de Reemplazo de Rodilla / Anestesia Local / Bloqueo Nervioso Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Orthop Surg Res Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Artroplastia de Reemplazo de Rodilla / Anestesia Local / Bloqueo Nervioso Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Orthop Surg Res Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido