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Ultrasound-guided genicular nerves block vs. local infiltration analgesia for total knee arthroplasty: a randomised controlled non-inferiority trial.
Cuñat, T; Mejía, J; Tatjer, I; Comino, O; Nuevo-Gayoso, M; Martín, N; Tió, M; Basora, M; Sala-Blanch, X.
Afiliación
  • Cuñat T; Anatomy and Embryology Department, School of Medicine, Universitat de Barcelona, Spain.
  • Mejía J; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Tatjer I; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Comino O; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Nuevo-Gayoso M; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Martín N; Knee Unit, Hospital Clinic de Barcelona, Spain.
  • Tió M; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Basora M; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
  • Sala-Blanch X; Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.
Anaesthesia ; 78(2): 188-196, 2023 02.
Article en En | MEDLINE | ID: mdl-36351436
Genicular nerves block is a promising technique to treat acute postoperative pain in total knee arthroplasty. Similar to surgeon-administered local infiltration analgesia, it targets sensory branches from the knee capsule, but through a selective ultrasound-guided injection that reduces local anaesthetic dose (150 ml ropivacaine 0.2% with local infiltration analgesia vs. 20 ml with genicular nerves block). This randomised non-inferiority trial compared the analgesic efficacy of genicular nerves block vs. local infiltration analgesia in the first 24 h following total knee arthroplasty. Sixty patients were randomly allocated to receive either ultrasound-guided block of five genicular nerves or local infiltration analgesia. The primary outcome was rest pain numeric rating scale (0-10) at 24 h. Secondary outcomes included pain numeric rating scale (rest and movement) and cumulative opioid consumption during the first 24 h. We analysed 29 patients in the genicular nerves block group and 30 in the local infiltration analgesia group. We found that the median difference (95%CI) in postoperative rest pain at 24 h (non-inferiority criteria, Δ = 1) was -1.0 (-2.0 to 1.0, p < 0.001). Median difference in cumulative opioid consumption was 0.0 mg (-3.0-5.0, p < 0.001) meeting the non-inferiority criteria, Δ = 23 mg. We conclude that genicular nerves block of five nerves provides non-inferior analgesia in the first 24 h following surgery compared with local infiltration analgesia, but with a considerable reduction in the local anaesthetic dose.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Analgesia / Bloqueo Nervioso Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Anaesthesia Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Analgesia / Bloqueo Nervioso Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Anaesthesia Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido