Implementation of a Multimodal Analgesic Strategy Including Continuous Femoral Nerve Block in Patients Undergoing Total Knee Arthroplasty
HTML Full Text (Inglês)
HTML Full Text (Espanhol)
PDF (Inglês)
PDF (Espanhol)
XML (Inglês)
XML (Espanhol)

Palavras-chave

Knee arthroplasty, Analgesia, Postoperative

Como Citar

Implementation of a Multimodal Analgesic Strategy Including Continuous Femoral Nerve Block in Patients Undergoing Total Knee Arthroplasty. (2019). Universitas Medica, 60(3), 1-7. https://doi.org/10.11144/Javeriana.umed60-3.mult
Almetrics
 
Dimensions
 

Google Scholar
 
Search GoogleScholar

Resumo

Total knee replacement is a painful surgical procedure. The inadequate control of postoperative pain is associated with adverse outcomes in the short and long term. Continuous femoral block has been shown to be effective and efficient as part of multimodal analgesia. This series of 48 patients who underwent total knee replacement, who received multimodal analgesic treatment including continuous femoral nerve block, documents the pain control profile during the first 48 hours. This is a successful experience of implementing regional techniques as part of perioperative pain relief, as documented in the literature. We emphasize that each institution must know its technical and human resource and characterize its patients, in order to implement multimodal analgesia protocols that include this regional technique. We also suggest to monitor and implement continuous improvement processes.

HTML Full Text (Inglês)
HTML Full Text (Espanhol)
PDF (Inglês)
PDF (Espanhol)
XML (Inglês)
XML (Espanhol)

1. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207-13. https://doi.org/10.1002/art.24021.

2. Grosu I, Lavand'homme P, Thienpont E. Pain after knee arthroplasty: an unresolved issue knee surgery. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1744-58. https://doi.org/10.1007/s00167-013-2750-2.

3. Chelly JE, Greger J, Gebhard R, Coupe K, Clyburn TA, Buckle R, et al. Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty. J Arthroplast 2001;16(4):436-45.

4. Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d'Athis F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology [internet]. 1999;(91):8-15. Disponible en: https://pdfs.semanticscholar.org/31d4/e3d1eda3b999431cf4558453ee8459c3571e.pdf

5. Parvizi J, Miller AG, Gandhi K. Multimodal pain management after total joint arthroplasty. J Bone Joint Surg Am. 2011;93(11):1075-84. https://doi.org/10.2106/JBJS.J.01095

6. Horlocker TT. Pain management in total joint arthroplasty: a historical review. Orthopedics. 2010;33(9 Suppl):14-9.

7. Singelyn FJ, Deyaert M, Joris D, Pendeville E, Gouverneur JM. Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth Analg. 1998;87(1):88-92.

8. Ganapathy S, Wasserman RA, Watson JT, Bennett J, Armstrong KP, Stockall CA, et al. Modified continuous femoral three-in-one block for postoperative pain after total knee arthroplasty. Anesth Analg 1999;89(5):1197-202.

9. Seet E, Leong WL, Yeo AS, Fook-Chong S. Effectiveness of 3-in-1 continuous femoral block of differing concentrations compared to patient controlled intravenous morphine for post total knee arthroplasty analgesia and knee rehabilitation. Anaesth Intensive Care. 2006;34(1):25-30.

10. Chan EY, Fransen M, Sathappan S, Chua NH, Chan YH, Chua N. Comparing the analgesia effects of single-injection and continuous femoral nerve blocks with patient controlled analgesia after total knee arthroplasty. J Arthroplasty. 2013;28(4):608-13.

11. Ey C, Fransen M, Parker DA, Assam PN, Chua N. Femoral nerve blocks for acute postoperative pain after knee replacement surgery. Cochrane Database Syst Rev. 2014;(5):CD009941. https://doi.org/10.1002/14651858.CD009941.pub2.

12. Paul JE, Arya A, Hurlburt L, Cheng J, Thabane L, Tidy A, et al. Femoral nerve block improves analgesia outcomes after ttal kee arthroplasty. Anesthesiology. 2010;103(5):1144-62.

13. Terkawi YS, Mavridis D, Sessler DI, Nunemaker MS, Doais KS, Terkawi RS, et al. Pain management modalities after total knee arthroplasty: a network meta-analysis of 170 randomized controlled trials. Anesthesiology. 2017;126(5):923-37. https://doi.org/10.1097/ALN.0000000000001607.

14. Ilfeld BM, Madison SJ. The sciatic nerve and knee arthroplasty to block, or not to block V that is the question. Anethes Pain Med. 2011;36(5):421-3.

15. Hussain N, et al. Adductor canal block versus femoral nerve block for total knee arthroplasty. Anesthesiology. 2014;120(3):540-50.

16. Elkassabany NM, Antosh S, Ahmed M, Nelson C, Israelite C, Badiola I, et al. The risk of falls after total knee arthroplasty with the use of a femoral nerve block versus an adductor canal block: a double-blinded randomized controlled study. Anesth Analg. 2016;122(5):1696-703. https://doi.org/10.1213/ANE.0000000000001237.

Esta revista científica se encuentra registrada bajo la licencia Creative Commons Reconocimiento 4.0 Internacional. Por lo tanto, esta obra se puede reproducir, distribuir y comunicar públicamente en formato digital, siempre que se reconozca el nombre de los autores y a la Pontificia Universidad Javeriana. Se permite citar, adaptar, transformar, autoarchivar, republicar y crear a partir del material, para cualquier finalidad (incluso comercial), siempre que se reconozca adecuadamente la autoría, se proporcione un enlace a la obra original y se indique si se han realizado cambios. La Pontificia Universidad Javeriana no retiene los derechos sobre las obras publicadas y los contenidos son responsabilidad exclusiva de los autores, quienes conservan sus derechos morales, intelectuales, de privacidad y publicidad.

El aval sobre la intervención de la obra (revisión, corrección de estilo, traducción, diagramación) y su posterior divulgación se otorga mediante una licencia de uso y no a través de una cesión de derechos, lo que representa que la revista y la Pontificia Universidad Javeriana se eximen de cualquier responsabilidad que se pueda derivar de una mala práctica ética por parte de los autores. En consecuencia de la protección brindada por la licencia de uso, la revista no se encuentra en la obligación de publicar retractaciones o modificar la información ya publicada, a no ser que la errata surja del proceso de gestión editorial. La publicación de contenidos en esta revista no representa regalías para los contribuyentes.