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. 2016 Sep;28(3):233-8.
doi: 10.5792/ksrr.2016.28.3.233. Epub 2016 Aug 25.

Comparative Effects of Periarticular Multimodal Drug Injection and Single-Shot Femoral Nerve Block on Pain Following Total Knee Arthroplasty and Factors Influencing Their Effectiveness

Shuji Nakagawa  1 , Yuji Arai  1 , Hiroaki Inoue  1 , Hiroyuki Kan  1 , Manabu Hino  1 , Shohei Ichimaru  1 , Kazuya Ikoma  1 , Hiroyoshi Fujiwara  1 , Fumimasa Amaya  2 , Teiji Sawa  2 , Toshikazu Kubo  1
Affiliations

Comparative Effects of Periarticular Multimodal Drug Injection and Single-Shot Femoral Nerve Block on Pain Following Total Knee Arthroplasty and Factors Influencing Their Effectiveness

Shuji Nakagawa et al. Knee Surg Relat Res. 2016 Sep.

Abstract

Purpose: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods.

Materials and methods: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90° of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated.

Results: The VAS scores did not differ significantly between two groups, whereas the amount of analgesics used was significantly lower in the LIA group. Preoperative flexion contracture was significantly more severe in the LIA group with high VAS compared with low VAS. No serious adverse event occurred in the LIA or FNB group.

Conclusions: The lower analgesic usage in the LIA group than the FNB group indicates that the analgesic effect of LIA was greater than that of singleshot FNB after TKA. There were no serious complications in either group. The postoperative analgesic effect of LIA was smaller in patients with severe than less severe preoperative flexion contracture.

Keywords: Arthroplasty; Femoral nerve block; Flexion contracture; Knee; Local infiltration analgesia.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Pain visual analog scale (VAS) score from the day of surgery to postoperative day (POD) 5 in the local infiltration analgesia (LIA) and femoral nerve block (FNB) groups. Both groups showed significant improvements in pain scores, and there were no significant differences between the two groups. The error bars indicate standard deviation.
See this image and copyright information in PMC

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