Postoperative analgesia and functional recovery after total-knee replacement: comparison of a continuous posterior lumbar plexus (psoas compartment) block, a continuous femoral nerve block, and the combination of a continuous femoral and sciatic nerve block.

摘要: Background and Objectives Continuous femoral nerve block is a well-accepted technique for regional analgesia after total-knee replacement. However, many patients still experience considerable pain at the popliteal space medial aspect of knee. The goal this study to evaluate whether psoas compartment catheter provides better postoperative than does it as effective combination sciatic and, thus, improves functional outcome. Methods Ninety who underwent replacement under standardized general anesthesia participated in prospective randomized study. Group FEM received continuous block, group FEM/SCI PSOAS block. Patient-controlled with piritramide was available 48 hours. Maximal bending extending knee walking distance assessed during first 7 days. A telephone survey conducted 9 to12 months residual Results Postoperative opioid consumption hours significantly less (median: 18 mg; 25th/75th percentile: 6/40) compared (49 25/66) (44 30/62) (P =.002). scores were not different, no differences occurred respect short-term or long-term Conclusion superior reduced analgesic requirements replacement, but outcome differ those 3 techniques.