Efficacy of Postoperative Analgesia Could be Improved by Adding Continuous Femoral Nerve Block to Epidural Anesthesia for Bilateral Total Knee Arthroplasty

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  • Nakamura Yosuke
    Department of Anesthesiology, Nihon University School of Medicine
  • Kato Jitsu
    Department of Anesthesiology, Nihon University School of Medicine
  • Shimizu Miho
    Department of Anesthesiology, Nihon University School of Medicine
  • Gokan Dai
    Department of Anesthesiology, Nihon University School of Medicine
  • Ogawa Yojiro
    Department of Social Medicine, Division of Hygiene, Nihon University School of Medicine
  • Ogawa Seturo
    Department of Anesthesiology, Nihon University School of Medicine

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Other Title
  • 両側人工膝関節置換術における，持続硬膜外鎮痛・持続大腿神経ブロック併用の有効性
  • リョウガワ ジンコウ ヒザカンセツ チカンジュツ ニ オケル,ジゾクコウマク ガイ チンツウ ・ ジゾク ダイタイ シンケイ ブロック ヘイヨウ ノ ユウコウセイ

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Abstract

Purpose: The purpose of this study was to investigate the efficacy and quality of postoperative analgesia by adding continuous femoral nerve block with ropivacaine (CFNB) to continuous epidural analgesia with ropivacaine (CEPA) for bilateral total knee arthroplasty (B-TKA). Methods: Thirty patients undergoing B-TKA in our hospital were included in this study. Postoperative pain intensities were recorded using visual analog pain scale (VAS) scores (0-100 mm) up to 48 hr after B-TKA, both at rest and during movement, following CEPA and CFNB in one leg (CFNB side). Analgesic effects and side effects on the CFNB and non-CFNB sides were compared in the same patient. Results: VAS scores were sig-nificantly different between the CFNB and non-CFNB sides (p < 0.001-0.05) both at rest and during movement. Supplemental analgesics, in the form of rectal suppositories and intramuscular injections, were used to reduce postoperative pain on the non-CFNB side. All patients complained of pain postoperatively only on the non-CFNB side. Six patients experienced nausea and another 6 experienced numbness of the leg as side effects. Conclusions: The present study indicates that CEPA combined with CFNB for analgesia following B-TKA could be a more suitable analgesic method than CEPA alone to reduce postoperative pain, both at rest and during movement, with few side effects.

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