Kaçmaz Mustafa, Turhan Zeynep Yüksel
Department of Anesthesiology, Ömer Halisdemir University Faculty of Medicine, Nigde, Turkey.
Department of Anesthesiology, Training and Research Hospital, Nigde, Turkey.
Geriatr Orthop Surg Rehabil. 2021 Feb 23;12:2151459321996632. doi: 10.1177/2151459321996632. eCollection 2021.
Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not.
A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB.
Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05).
When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction.
We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.
股神经阻滞（FNB）和收肌管阻滞（ACB）方法作为区域镇痛技术，已成功用于全膝关节置换术后的疼痛控制。本研究旨在比较在接受脊髓麻醉的全膝关节置换术（TKA）患者中，术前使用的收肌管阻滞方法和股神经阻滞方法对患者满意度的影响因素，并确定这些方法是否同样有效。
本随机研究前瞻性纳入了80例年龄在60至75岁之间、美国麻醉医师协会（ASA）身体状况为I - III级的患者。接受FNB的患者（n = 40）被称为FNB组，接受收肌管阻滞的患者（n = 40）被称为ACB组。
虽然仅在术后第一小时FNB组的平均视觉模拟评分（VAS）值较低（p = 0.02），但在第三、第五、第七、第九、第十二和第二十四小时，两组之间无显著差异（p≥0.05）。虽然在第一、第二、第三、第四和第五小时FNB组的布罗玛杰评分较低，但两组之间无统计学显著差异（p≥0.05）。比较活动时间、患者满意度水平、首次镇痛时间、术中镇静需求和感觉阻滞恢复时间时，未发现统计学显著差异（p≥0.05）。
在全膝关节置换术患者中，比较用于术后镇痛的ACB和FNB对患者满意度的影响因素时，发现它们导致相同水平（非劣效性）的患者满意度。
我们建议在全膝关节置换术中常规使用ACB方法联合FNB。需要更多专门关注测量患者满意度的研究。
