TY - JOUR
TI - Continuous femoral nerve block provides superior analgesia compared with continuous intra-articular and wound infusion after anterior cruciate ligament reconstruction
AU - Dauri, M.
AU - Fabbi, E.
AU - Mariani, P.
AU - Faria, S.
AU - Carpenedo, R.
AU - Sidiropoulou, T.
AU - Coniglione, F.
AU - Silvi, M.B.
AU - Sabato, A.F.
JO - Regional Anesthesia and Pain Medicine
PY - 2009
VL - 34
TODO - 2
SP - 95-99
PB - 
SN - 1098-7339, 1532-8651
TODO - 10.1097/AAP.0b013e31819baf98
TODO - clonidine;  ketorolac;  morphine;  ropivacaine, adult;  analgesia;  anterior cruciate ligament reconstruction;  article;  clinical article;  clinical trial;  continuous infusion;  controlled study;  device;  female;  femoral nerve;  human;  male;  nerve block;  postoperative analgesia;  postoperative pain;  priority journal;  visual analog scale, Adolescent;  Adult;  Amides;  Anterior Cruciate Ligament;  Catheters, Indwelling;  Clonidine;  Female;  Femoral Nerve;  Humans;  Infusion Pumps;  Injections, Intra-Articular;  Ketorolac;  Male;  Middle Aged;  Morphine;  Nerve Block;  Orthopedic Procedures;  Pain Measurement;  Patellar Ligament;  Prospective Studies;  Reconstructive Surgical Procedures;  Sciatic Nerve;  Young Adult
TODO - Background and Objectives: This prospective, randomized, clinical trial compared pain intensity and analgesic drug consumption after anterior cruciate ligament (ACL) reconstruction with patellar tendon under femoral-sciatic nerve block anesthesia in patients who received either a continuous femoral nerve block (CFNB) or continuous local anesthetic wound and intra-articular infusions. Methods: Fifty patients were randomized to CFNB (n = 25) or an ON-Q device (I-Flow Corp, Lake Forest, Calif) (n = 25). All patients received sciatic nerve block (25 mL of ropivacaine 7.5 mg/mL and clonidine 30 μg). The first group received a CFNB (2 mg/mL of ropivacaine at 7 mL/hr), and the second group received a single-shot femoral nerve block (both using 25 mL of ropivacaine 7.5 mg/mL and clonidine 30 μg). At the end of the intervention, an ON-Q device was positioned on the ON-Q patients to continuously infuse the patellar tendon wound and intra-articular cavity with ropivacaine 2 mg/mL at 2 mL/hr for each catheter. Data regarding demographic, hemodynamic, pain scores, adverse effects, and need for supplemental analgesia were registered in a 36-hr follow-up period. Results: The CFNB group reported lower visual analog scale values than the ON-Q group: at rest at 12 hrs (2.4 [SD, 2.2] vs 5.4 [SD, 3.1]; P < 0.001) and on movement at 12 (3.1 [SD, 2.5] vs 6.3 [SD, 2.9]; P < 0.001) and 24 hrs (2.7 [SD, 1.9] vs 4.6 [SD, 2.6]; P = 0.01) after surgery. The number of morphine and ketorolac boluses was lower in the CNFB group (morphine: 3.2 [SD, 2.2] vs 6.2 [SD, 2.5]; P < 0.001; ketorolac: 1.1 [SD, 1.0] vs 2.4 [SD, 0.9]; P < 0.001). Conclusion: Continuous femoral nerve block provides better analgesia than the continuous patellar tendon wound and intra-articular infusions after anterior cruciate ligament reconstruction with patellar tendon. Copyright © 2009 by American Society of Regional Anesthesia and Pain Medicine.
ER -