Department of Anaesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Anaesthesiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Anaesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands.
Br J Anaesth. 2018 Oct;121(4):850-858. doi: 10.1016/j.bja.2018.05.069. Epub 2018 Jul 26.
The aim was to compare the effects on short-term and long-term pain and functional outcome of periarticular local anaesthetic infiltration (LIA) with LIA of the posterior knee capsule in combination with a femoral nerve block (FNB) catheter in patients undergoing total knee arthroplasty.
Eighty patients were randomised to one of two groups: Subjects in group LIA received periarticular LIA with ropivacaine 0.2% for postoperative analgesia; subjects in group FNB received LIA of the posterior capsule and a FNB catheter. The primary outcome parameter was functional capacity of the knee 12 months after surgery. Secondary parameters included mobility as determined by accelerometer data, pain, satisfaction with the analgesic regimen, hospital length of stay, and use of pain medication 3 and 12 months after surgery.
There were no differences between groups in long-term functional capacity, patient satisfaction and hospital length of stay. In the first 2 days, subjects in group FNB had slightly lower pain scores and used less opioids, and subjects in group LIA had a higher level of accelerometer activity. Three and 12 months after surgery, subjects in group FNB had lower maximum pain scores and were less likely to use any pain medication 12 months after surgery.
Both techniques were similar regarding long-term functional outcome. Subjects in group FNB had slightly lower pain scores and lower opioid consumption after operation, lower maximum pain scores at 3 and 12 months, and were less likely to use any pain medication at 12 months.
NCT01966263.
本研究旨在比较膝关节周围局部麻醉浸润（LIA）联合股神经阻滞（FNB）导管与单纯膝关节后囊 LIA 对全膝关节置换术后短期和长期疼痛及功能结果的影响。
80 例患者随机分为两组：LIA 组接受罗哌卡因 0.2%行膝关节周围 LIA 以用于术后镇痛；FNB 组接受膝关节后囊 LIA 和 FNB 导管。主要结局参数为术后 12 个月膝关节的功能能力。次要参数包括术后 3 个月和 12 个月的移动性（通过加速度计数据确定）、疼痛、对镇痛方案的满意度、住院时间和术后 3 个月和 12 个月的疼痛药物使用情况。
两组间在长期功能能力、患者满意度和住院时间方面无差异。在最初的 2 天内，FNB 组疼痛评分略低，阿片类药物用量较少，LIA 组加速度计活动水平较高。术后 3 个月和 12 个月时，FNB 组的最大疼痛评分较低，术后 12 个月时更不可能使用任何止痛药。
两种技术在长期功能结果方面相似。FNB 组术后疼痛评分和阿片类药物用量略低，术后 3 个月和 12 个月时最大疼痛评分较低，术后 12 个月时更不可能使用任何止痛药。
NCT01966263。
