The effectiveness of femoral/sciatic nerve blocks on postoperative pain management in total knee arthroplasty.

摘要

PURPOSE: Total knee arthroplasty (TKA) generates severe postoperative pain in 60% of patients and moderate pain in 30% of patients. Lack of adequate pain control can hinder early intensive physical therapy, the most influential factor for a good outcome. The purpose of this study was to evaluate the effectiveness of the femoral/sciatic block with postoperative pain management in comparison with conventional pain management in patients who have undergone unilateral primary TKA. SAMPLE: Following unilateral TKA, 130 patients were evaluated: 65 in the general/spinal group and 65 in the general/femoral/sciatic group. METHODS: This is a retrospective, comparative study. Participants who underwent primary TKA were randomly selected from a computer list generated by the hospitals medical records department between May 2001 to May 2002 and May 2004 to May 2005. Data collected included demographics, anesthesia type, knee range of motion, pain scores, complications, and length of stay. FINDINGS: The general/femoral/sciatic group members experienced less pain as evidenced by the lower visual analog scale scores and less use of adjunct narcotics. They also performed better with increased knee flexion and extension scores than those in the general/spinal group. There was no difference in length of stay or significant differences between the groups with medical complications. DISCUSSION: Findings indicate that femoral/sciatic nerve blocks in unilateral TKA are an effective method of postoperative pain management.