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Low concentration continuous femoral nerve block improves analgesia and functional outcomes after total knee arthroplasty in spinal anesthesia
Anesth Pain Med 2018;13(4):439-46
Published online October 31, 2018
© 2018 Korean Society of Neuroscience in Anesthesiology and Critical Care.

So Hui Yun1, Yun Suk Choi1 , and Sang Rim Kim2
1Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University School of Medicine, 2Department of Orthopedic Surgery, Jeju National University Hospital, Jeju, Korea
Correspondence to: Yun Suk Choi, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Korea
Tel: 82-64-717-2025
Fax: 82-64-717-2042
E-mail: solafide5@yahoo.co.kr
ORCID
http://orcid.org/0000-0002-7983-8089
Received January 23, 2018; Revised June 19, 2018; Accepted July 4, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Total knee arthroplasty (TKA) is associated with severe pain postoperatively. Femoral nerve block is commonly used for pain control after TKA. This study investigated whether continuous femoral nerve block (CFNB) can improve postoperative analgesia and functional outcome as compared to intravenous patient controlled analgesia (PCA) in patients with TKA.
Methods: We reviewed the electronic medical records of patients who underwent TKA with spinal anesthesia between March 2014 and February 2015. In Group IV, postoperative pain was managed by IV-PCA. Group CFNB received CFNB-PCA via a device. Thirty patients were enrolled per group. Patient outcomes were assessed by analgesia, functional outcomes, and health-related quality of life factors.
Results: Additional analgesics and additional nerve block for adequate pain control were significantly more frequent in the IV than CFNB group (P = 0.015 and P = 0.012, respectively). Range of motion up to 105 degrees was prolonged in the IV group than CFNB group (P = 0.013). EuroQol five dimensions score was improved in the CFNB group than IV group postoperative 3 weeks (P = 0.003). The incidence of transfusion due to postoperative bleeding was significantly frequent in the IV group than CFNB group (P = 0.042).
Conclusions: Postoperative low concentration continuous femoral nerve block for analgesia after TKA improves analgesia, functional outcomes, and incidence of transfusion without falling risk.
Key Words : Blood transfusion; Femoral nerve; Knee replacement arthroplasty; Nerve block; Patient-controlled analgesia; Patient outcome assessments.


October 2018, 13 (4)
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