Continuous epidural analgesia versus continuous femoral nerve block in management of post-operative pain in patients undergoing unilateral total knee arthroplasty: An open labelled randomized controlled trial
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 1, Pages 711-718
AbstractIntroduction: The most common concern associated with TKR is post-operative pain for
both the patient and the surgeon. It is associated with multiple adverse physical and
psychological consequences, which hinder postoperative mobilisation, increase the incidence
of post-operative complications and the overall outcome.A number of modalities have been
recommended of which regional techniques are preferred. Current study aims to compare
post-operative management of pain in patients undergoing Total Knee arthroplasty (TKA)
with epidural analgesia versus femoral nerve block.
Material and methods: Study was done in 100 patients posted for unilateral TKA. After
obtaining written consent and ethical committee clearance patients were randomized in to two
groups. Group “CEA”-8 mL 0.2% ropivacaine was given epidurally and Group “CFB”-bolus
of 20 mL of 0.2% ropivacaine was given through femoral catheter.
Outcomes assessed were
1) Acute postoperative pain (during rest and movement).
2) Postoperative rescue analgesic consumption/rescue analgesia.
3) Quality of early postoperative rehabilitation (functional assessments).
4) Postoperative complications if any.
Results: There was no significant difference in Vas score during rest and activity in both the
groups at 6 hrs,12, 24, 48 and 72 hours. There was no significant difference in both the
groups with respect to rehabilitation indices and adverse events. Only 43.4% of patients
belonging to group CFB, received rescue analgesia which was less when compared to patients
in group CEA(57.6%) which was significant.
Conclusion: CFA have the advantage over CEA in terms of decreased need for rescue.
analgesia with no neuraxial side effects.
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