Femoral nerve block-sciatic nerve block vs. femoral XXXX -local infiltration analgesia for total knee arthroplasty: a randomized controlled trial.

@entity1 @entity390 @entity1425 @entity1337 @entity391 @entity1342 @entity158 @entity282 @entity616
BACKGROUND: The use of femoral @entity616 (FNB) combined with sciatic @entity616 (SNB) after total knee arthroplasty (TKA) has recently become controversial. @entity1337 ( @entity1337 ) has been reported to be effective for postoperative @entity158 control. We aimed to assess whether @entity1337 with continuous FNB is as effective as SNB combined with continuous FNB. METHODS: This was a prospective, randomized, single-center, observer-blinded, parallel group comparison trial of 34 American Society of Anesthesiologists (ASA) physical status 1-3 @entity1 who underwent TKA and fulfilled the inclusion and exclusion criteria. @entity1 were randomized into two groups: a periarticular @entity1337 and FNB group (group L, n   =   17), and an SNB and FNB group (group S, n   =   17). In both groups, @entity1 received FNB with 20  mL of 0.375  % @entity1342 , and 5  mL  h(-1) of 0.2  % @entity1342 after surgery. In group L, @entity1 received 100-ml injections of 0.2  % @entity1342 and 0.5  mg @entity1425 to the surgical region. In group S, @entity1 received SNB with 20  ml of 0.375  % @entity1342 . After TKA, Numeric Rating Scale (NRS) scores for the first 24  h post-operation were compared via repeated-measures analysis of variance (ANOVA) as the primary outcome. Other outcome measures included NRS score changes within groups, area under the curve for the NRS scores, total analgesic dose, change in knee flexion and extension, @entity158 control satisfaction, @entity390 and @entity391 , and hospital stay duration. RESULTS: NRS score changes were greater in group L than in group S (P   <   0.01, ANOVA) and greater in group L than in group S at three postoperative time points: 3  h (P   <   0.01), 6  h (P   <   0.01), and 12  h (P   =   0.013; Mann-Whitney U test). Changes in the mean NRS score were observed in each group (P   <   0.01, Friedman test). No significant differences were detected in the other outcome measures (Mann-Whitney U, Wilcoxon signed-rank, and chi-squared tests). CONCLUSIONS: Sciatic @entity616 with femoral @entity616 is superior to local anesthetic infiltration with femoral @entity616 for @entity282 control within 3-12  h of total knee arthroplasty. TRIAL REGISTRATION: UMIN-CTR ID: 000013364 R: 000015591.
