The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial

Background Ultrasound-guided femoral triangle block (FTB) can provide motor-sparing anterior knee analgesia. However, it may not completely anesthetize the anterior femoral cutaneous nerve (AFCN). We hypothesized that an AFCN block (AFCNB) in combination with an FTB would decrease pain during moveme...

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Autores principales:	Wirinaree Kampitak, Aree Tanavalee, Tanvaa Tansatit, Srihatach Ngarmukos, Nattaporn Songborassamee, Chutikant Vichainarong
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society of Anesthesiologists 2021
Materias:	arthroplasty knee nerve block peripheral nerves postoperative pain ultrasonography Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/71f826381f2749d4b3a9223700850133
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spelling	oai:doaj.org-article:71f826381f2749d4b3a92237008501332021-11-30T23:47:49ZThe analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial2005-64192005-756310.4097/kja.21120https://doaj.org/article/71f826381f2749d4b3a92237008501332021-12-01T00:00:00Zhttp://ekja.org/upload/pdf/kja-21120.pdfhttps://doaj.org/toc/2005-6419https://doaj.org/toc/2005-7563Background Ultrasound-guided femoral triangle block (FTB) can provide motor-sparing anterior knee analgesia. However, it may not completely anesthetize the anterior femoral cutaneous nerve (AFCN). We hypothesized that an AFCN block (AFCNB) in combination with an FTB would decrease pain during movement in the immediate 12 h postoperative period compared with an FTB alone. Methods Eighty patients scheduled to undergo total knee arthroplasty were randomized to receive either FTB alone (FTB group) or AFCNB with FTB (AFCNB + FTB group) as part of the multimodal analgesic regimen. The primary outcome was pain during movement at 12 h postoperatively. Secondary outcomes included numeric rating scale (NRS) pain scores, incidence of surgical incision site pain, intravenous morphine consumption, immediate functional performance, patient satisfaction, and length of hospital stay. Results The NRS pain scores on movement 12 h postoperatively were significantly lower in the AFCNB + FTB group than in the FTB group (mean difference: –2.02, 95% CI: –3.14, –0.89, P < 0.001). The incidence of pain at the surgical incision site at 24 h postoperatively and morphine consumption within 48 h postoperatively were significantly lower (P < 0.001), and quadriceps muscle strength at 0° immediately after surgery was significantly greater in the AFCNB + FTB group (P = 0.04). Conclusions The addition of ultrasound-guided AFCNB to FTB provided more effective analgesia and decreased opioid requirement compared to FTB alone after total knee arthroplasty and may enhance immediate functional performance on the day of surgery.Wirinaree KampitakAree TanavaleeTanvaa TansatitSrihatach NgarmukosNattaporn SongborassameeChutikant VichainarongKorean Society of Anesthesiologistsarticlearthroplastykneenerve blockperipheral nervespostoperative painultrasonographyAnesthesiologyRD78.3-87.3ENKorean Journal of Anesthesiology, Vol 74, Iss 6, Pp 496-505 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	arthroplasty knee nerve block peripheral nerves postoperative pain ultrasonography Anesthesiology RD78.3-87.3
spellingShingle	arthroplasty knee nerve block peripheral nerves postoperative pain ultrasonography Anesthesiology RD78.3-87.3 Wirinaree Kampitak Aree Tanavalee Tanvaa Tansatit Srihatach Ngarmukos Nattaporn Songborassamee Chutikant Vichainarong The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
description	Background Ultrasound-guided femoral triangle block (FTB) can provide motor-sparing anterior knee analgesia. However, it may not completely anesthetize the anterior femoral cutaneous nerve (AFCN). We hypothesized that an AFCN block (AFCNB) in combination with an FTB would decrease pain during movement in the immediate 12 h postoperative period compared with an FTB alone. Methods Eighty patients scheduled to undergo total knee arthroplasty were randomized to receive either FTB alone (FTB group) or AFCNB with FTB (AFCNB + FTB group) as part of the multimodal analgesic regimen. The primary outcome was pain during movement at 12 h postoperatively. Secondary outcomes included numeric rating scale (NRS) pain scores, incidence of surgical incision site pain, intravenous morphine consumption, immediate functional performance, patient satisfaction, and length of hospital stay. Results The NRS pain scores on movement 12 h postoperatively were significantly lower in the AFCNB + FTB group than in the FTB group (mean difference: –2.02, 95% CI: –3.14, –0.89, P < 0.001). The incidence of pain at the surgical incision site at 24 h postoperatively and morphine consumption within 48 h postoperatively were significantly lower (P < 0.001), and quadriceps muscle strength at 0° immediately after surgery was significantly greater in the AFCNB + FTB group (P = 0.04). Conclusions The addition of ultrasound-guided AFCNB to FTB provided more effective analgesia and decreased opioid requirement compared to FTB alone after total knee arthroplasty and may enhance immediate functional performance on the day of surgery.
format	article
author	Wirinaree Kampitak Aree Tanavalee Tanvaa Tansatit Srihatach Ngarmukos Nattaporn Songborassamee Chutikant Vichainarong
author_facet	Wirinaree Kampitak Aree Tanavalee Tanvaa Tansatit Srihatach Ngarmukos Nattaporn Songborassamee Chutikant Vichainarong
author_sort	Wirinaree Kampitak
title	The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
title_short	The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
title_full	The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
title_fullStr	The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
title_full_unstemmed	The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
title_sort	analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial
publisher	Korean Society of Anesthesiologists
publishDate	2021
url	https://doaj.org/article/71f826381f2749d4b3a9223700850133
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The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial

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