Multimodal neural block analgesia versus morphine analgesia after elective knee surgery
Journal Title: Scripta Medica (Banja Luka) - Year 2019, Vol 50, Issue 3
Abstract
Background: Total knee arthroplasty has become a standard for treatment of endstage knee osteoarthritis. Due to intense and complex knee innervation, there is a need to improve the anaesthetic/analgesic approach to such operations. The aim of this randomised clinical trial was to compare the analgesic efficacy of the classical regimen and two of those based on the nerve blocks. Methods: A total of 60 patients was included and subjected to elective total knee arthroplasty under the general balanced anaesthesia. They were randomised to receive postoperatively (1) only morphine 5-10 mg q6h and paracetamol 1 g q6h (MP), (2) femoral nerve block (FNB) or (3) fascia iliac compartment nerve block (FICNB). Nerve blocks were produced by a single administration of 30-40 ml of bupivacaine 0.5%. Pain intensity, duration of neural block and additional consumption of analgesics were recorded postoperatively. Results: There were no demographic differences among the three groups of patients. Pain intensity was significantly lower in the two nerve block groups than in the MP group. The same two groups also demanded significantly less analgesics postoperatively than the MP group. Cardiovascular control was significantly better in the nerve block groups. There were no significant differences between the FNB and FICNB groups of patients regarding any of the studied parameters. Conclusion: In comparison with the classical MP analgesia, use of FNB or FICNB after the elective total knee arthroplasty results in lower pain scores, lower systolic blood pressure and less consumption of analgesics in the immediate postoperative course.
Authors and Affiliations
Dragana Lončar-Stojiljković
Keywords
Related Articles
- EP ID EP673333
- DOI 10.5937/scriptamed50-22948
- Views 290
- Downloads 0
Dermal regeneration with MilliGraft® kit of nanofat: the micrograft of adipose tissue. A clinical assessment study
The simple filtration by means of the MilliGraft ® Kit of a disaggregated lipoaspirate allows to extract the class of cells defined as progentors with characteristics of adult stem cells present in the nanofat exclusivel...
Renin-angiotensin and kallikrein-kinin systems in diabetic retinopathy
This brief review describes how two complex systems, the renin-angiotensin system (RAS) and the kallikrein-kinin system (KKS), affect the retina. It emphasises the important physiological actions of components of these s...
Multimodal neural block analgesia versus morphine analgesia after elective knee surgery
Background: Total knee arthroplasty has become a standard for treatment of endstage knee osteoarthritis. Due to intense and complex knee innervation, there is a need to improve the anaesthetic/analgesic approach to such...
The effects of certain gasotransmitters inhibition on homocysteine acutely induced changes on rat cardiac acetylcholinesterase activity
Background/Aim: Hyperhomocysteinaemia is linked to higher level of acetylcholinesterase (AChE) in brain, but there is insufficient information on influence of homocysteine (Hcy) and gasotransmitters on cardiac AChE. Thus...
Quality of life in children with epilepsy
Children with epilepsy are a particularly sensitive part of population and require continuous monitoring by neuro-paediatricians, so that any behavioural and functional changes that occur during mental maturation from th...