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ORIGINAL ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 326-330

Evaluating analgesic efficacy of single femoral nerve block versus combined femoral-sciatic nerve block post total knee arthroplasty


1 Department of Anesthesiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
2 Department of Anesthesiology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
3 Department of Orthopedics, KGMU, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Divya Arora
Department of Anesthesiology, BRD Medical College, Gorakhpur, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_78_20

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Background: With increasing knee replacement surgeries, there has been a constant search for effective pain control modality. Aims: We compared the analgesic effect of femoral nerve block (FNB) alone with combined femoral and sciatic nerve block (SNB) for postoperative pain management after total knee arthroplasty (TKA). Setting and Design: This was a prospective observational study. Methods: A total of 150 adult patients of American Society of Anesthesiologists physical status class I and II scheduled for elective TKA under spinal anesthesia with 3.4-mL bupivacaine 0.5% and 20-μg fentanyl were randomly allocated to two groups. Group F patients received a single shot FNB with 20 ml 0.375% ropivacaine and Group FS patients received combined FNB with 20 mL of 0.375% ropivacaine and SNB with 40 ml of 0.375% ropivacaine at the end of surgery. The primary outcome was the change in Numeric Rating Scale (NRS) scores between Groups F and FS at 6, 12, 18, 24, and 48 h later. The secondary outcome was total doses of opioid required in both groups. Results: The demographic data were comparable in both groups. The NRS scores were higher and statistically significant in Group F than that in Group FS at all five measured time points (P < 0.00001), and the total pain score with a mean of 15.43 in Group F and a mean of 9.61 in Group FS was statistically significant. Significantly more opioid consumption was seen postoperatively in Group F as compared to Group FS at 12, 18, 24, and 48 h as depicted by P < 0.00001. Conclusions: We conclude that the FNB, when combined with SNB, shows superior results than femoral block alone. SNB reduced pain scores and opiate consumption postoperatively up to 48 h.


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