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Open AccessArticle
Evaluation of Postoperative Pain When Adding a Tibial Nerve Block to the Femoral Nerve Block for Total Knee Arthroplasty
by
Alejandra Mira-Puerto
Alejandra Mira-Puerto 1,*
,
Pedro Romero-Aroca
Pedro Romero-Aroca 2
,
Alfredo Rodríguez-Gangoso
Alfredo Rodríguez-Gangoso 3
,
Albert Ferrando-de Jorge
Albert Ferrando-de Jorge 3
,
Mireia Duart-Oltra
Mireia Duart-Oltra 1,
Pilar Sala-Francino
Pilar Sala-Francino 1,
Mari Carmen Martínez-Segovia
Mari Carmen Martínez-Segovia 4 and
Marc Baget-Bernaldiz
Marc Baget-Bernaldiz 2
1
Anaesthetic Service, Hospital Universitat Sant Joan, Institut d’Investigació Sanitària Pere Virgili [IISPV], Universitat Rovira i Virgili, 43204 Reus, Spain
2
Ophthalmology Service, Hospital Universitat Sant Joan, Institut d’Investigació Sanitària Pere Virgili [IISPV], Universitat Rovira i Virgili, 43204 Reus, Spain
3
Traumatology Service, Hospital Universitat Sant Joan, Institut d’Investigació Sanitària Pere Virgili [IISPV], Universitat Rovira i Virgili, 43204 Reus, Spain
4
Anaesthetic Service, Hospital Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(15), 4387; https://doi.org/10.3390/jcm13154387 (registering DOI)
Submission received: 16 June 2024
/
Revised: 21 July 2024
/
Accepted: 22 July 2024
/
Published: 26 July 2024
Abstract
Background: The aim of this study was to compare the postoperative analgesic efficacy when a tibial nerve block was added to the femoral nerve block for total knee arthroplasty (TKA). Methods: A total of 60 patients were randomly assigned to the experimental group (EG) or the control group (CG) in a 1:1 ratio. The thirty patients who formed the CG underwent an ultrasound-guided femoral nerve block together with neuraxial anaesthesia and the administration of opioids and NSAIDs through an intravenous elastomeric pump for the management of the postoperative pain; the other thirty, who formed the EG, underwent neuraxial anaesthesia together with femoral and tibial nerve blocks. The efficacy of the analgesic effect was evaluated based on the numerical pain rating scale (NPRS) and on the need for analgesic rescue at different time intervals within 48 h after surgery. Results: At 24 h, the mean NPRS score in the EG and CG at rest was 1.50 ± 1.19 and 1.63 ± 1.60 [U = 443.5, p = 0.113], respectively. With joint movement, the mean NPRS score was 2.80 ± 1.49 and 3.57 ± 1.79 [U = 345, p = 0.113], respectively. Ten patients in the EG [33.3%] and 24 in the CG [80%] required rescue analgesia [Phi = 0.471, p < 0.001]. At 48 h, the mean NPRS score in the EG and CG at rest was 0.33 ± 0.60 and 0.43 ± 0.72 [U = 428, p = 0.681], respectively. With movement, the mean NPRS score was 1.03 ± 0.99 in the EG and 1.60 ± 1.07 in the CG [U = 315, p = 0.038]. No patient in the EG group required rescue analgesia, while three patients in the CG [10%] did [Phi = 0.229, p = 0.076]. The mean opioid dosage in the CG was 300 mg, whereas in the EG it was 40 mg ± 62.14 [U < 0.05, p < 0.001]. Conclusions: Adding a tibial nerve block to the femoral nerve block in TKA may achieve the same analgesic efficacy within 48 h after surgery and would reduce the systematic use of opioids.
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MDPI and ACS Style
Mira-Puerto, A.; Romero-Aroca, P.; Rodríguez-Gangoso, A.; Ferrando-de Jorge, A.; Duart-Oltra, M.; Sala-Francino, P.; Martínez-Segovia, M.C.; Baget-Bernaldiz, M.
Evaluation of Postoperative Pain When Adding a Tibial Nerve Block to the Femoral Nerve Block for Total Knee Arthroplasty. J. Clin. Med. 2024, 13, 4387.
https://doi.org/10.3390/jcm13154387
AMA Style
Mira-Puerto A, Romero-Aroca P, Rodríguez-Gangoso A, Ferrando-de Jorge A, Duart-Oltra M, Sala-Francino P, Martínez-Segovia MC, Baget-Bernaldiz M.
Evaluation of Postoperative Pain When Adding a Tibial Nerve Block to the Femoral Nerve Block for Total Knee Arthroplasty. Journal of Clinical Medicine. 2024; 13(15):4387.
https://doi.org/10.3390/jcm13154387
Chicago/Turabian Style
Mira-Puerto, Alejandra, Pedro Romero-Aroca, Alfredo Rodríguez-Gangoso, Albert Ferrando-de Jorge, Mireia Duart-Oltra, Pilar Sala-Francino, Mari Carmen Martínez-Segovia, and Marc Baget-Bernaldiz.
2024. "Evaluation of Postoperative Pain When Adding a Tibial Nerve Block to the Femoral Nerve Block for Total Knee Arthroplasty" Journal of Clinical Medicine 13, no. 15: 4387.
https://doi.org/10.3390/jcm13154387
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