In patients undergoing fast track total knee arthroplasty, addition of buprenorphine to a femoral nerve block has no clinical advantage: A prospective, double-blinded, randomized, placebo controlled trial.
作者信息
van Beek Rienk, Zonneveldt Harry J, van der Ploeg Tjeerd, Steens Jeroen, Lirk Phillip, Hollmann Marcus W
机构信息
Department of Anesthesiology, Westfriesgasthuis, Hoorn, The Netherlands Westfriesleerhuis, Westfriesgasthuis, Hoorn, The Netherlands Department of Orthopedic Surgery, Westfriesgasthuis, Hoorn, The Netherlands Department of Anesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.
出版信息
Medicine (Baltimore). 2017 Jul;96(27):e7393. doi: 10.1097/MD.0000000000007393.
BACKGROUND
Several adjuvants have been proposed to prolong the effect of peripheral nerve blocks, one of which is buprenorphine. In this randomized double blinded placebo controlled trial we studied whether the addition of buprenorphine to a femoral nerve block prolongs analgesia in patients undergoing total knee arthroplasty in a fast track surgery protocol.
METHODS
The treatment group (B) was given an ultrasound-guided femoral nerve block with ropivacaine 0.2% and 0.3mg buprenorphine. We choose to use 2 control groups. Group R was given a femoral nerve block with ropivacaine 0.2% only. Group S also received 0.3 mg buprenorphine subcutaneously. Only patients with a successful block were enrolled in the study.
RESULTS
We found no difference in our primary outcome parameter of time to first rescue analgesic. We found lower opioid use and better sleep quality the first postoperative night in patients receiving buprenorphine perineurally or subcutaneously. Buprenorphine did not lead to any significant change in pain or mobilization. We found a high overall incidence of nausea and vomiting.
CONCLUSION
In patients undergoing total knee arthroplasty, in the setting of a fast track surgery protocol, the addition of buprenorphine to a femoral nerve block did not prolong analgesia.
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