Τίτλος:
Continuous femoral nerve block provides superior analgesia compared with continuous intra-articular and wound infusion after anterior cruciate ligament reconstruction
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Dauri, M.
Fabbi, E.
Mariani, P.
Faria, S.
Carpenedo, R.
Sidiropoulou, T.
Coniglione, F.
Silvi, M.B.
Sabato, A.F.
Περιοδικό:
Regional Anesthesia and Pain Medicine
Λέξεις-κλειδιά:
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
DOI:
10.1097/AAP.0b013e31819baf98
