The Efficacy of Local Infiltration Analgesia Comparison with Single Femoral Nerve Block After Total Knee Arthroplasty under Spinal Anesthesia with Morphine

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Hadchaporn Kheawbanyang


Background: The femoral nerve block (FNB) and local infiltration analgesia (LIA) were the techniques used for the pain management after total knee arthroplasty (TKA). The effectiveness of analgesic effect after TKA between FNB and LIA is controversial. We compared the efficacy in post operative TKA pain reduction between femoral nerve block and local infiltration analgesia. Methods: Forty patients undergoing elective TKA under

spinal anesthesia with morphine 0.2 mg were randomly assigned to receive FNB or LIA group. We recorded

additional tramadol consumption for pain control, pain score in the first 24 postoperative hours and side effects of analgesia. Results: Mean tramadol consumption was significantly lower in LIA group than FNB group during first 24 postoperative hours : 37.50 ± 27.50 vs 77.50 ± 52.49 mg (p = 0.001). Less proportion of patients in LIA group needed tramadol compared to FNB group : 70 % vs 95% (p = 0.090). Mean time to first dose tramadol request was significantly lower in LIA group than FNB group: 514.50 ± 309.50 vs 1018.50 ± 383.63 mg (p < 0.001). Mean pain score was significantly lower in LIA group compared to FNB group during first 12 postoperative hours. There were no differences in side effect, dose of metoclopramide, and chlorpheniramine used between two groups. Conclusion: LIA techniques provide better pain relief and low tramadol consumption after TKA than FNB technique.

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