Analysis of Postoperative Analgesic Effect and Complications Among Different Approaches of Nerve Block for Total Knee Replacement Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 126
- 试验地点
- 1
- 主要终点
- Acute postoperative pain
研究概览
简要总结
This study is a retrospective analysis using the accumulated clinical database from 2017/09-2023/12 to analyze patients who underwent total knee arthroplasty and received nerve blocks. The aim is to compare the analgesic effects, incidence of nerve injury, and rate of chronic pain under different nerve block techniques.
详细描述
Protocol title: Analysis of postoperative analgesic effect and complications among different approaches of nerve block for total knee replacement surgery Objectives: There is no consensus on the optimal nerve block choice for knee joint replacement. Therefore, the aim of this study is to conduct a retrospective analysis using data from patients who underwent total knee replacement (TKR) and received nerve blocks at our hospital. This study will investigate the postoperative analgesic consumption, duration of pain relief, motor function block, complications, and patient satisfaction for different nerve block techniques. The goal of this project is to identify the optimal nerve block choice to benefit future patients undergoing knee joint replacement.
Background: After undergoing total knee replacement (TKR), patients need rehabilitation to restore knee function and reduce postoperative adhesions. However, pain often prevents them from achieving this goal. Clinically, nerve block anesthesia is gradually becoming mainstream, as it achieves intraoperative anesthesia and postoperative analgesia by infiltrating local anesthetics into the nerves supplying the knee joint. According to a study by Allen et al. (1998), patients receiving nerve blocks such as femoral and sciatic nerve blocks experienced better pain relief within the first 8 hours postoperatively and had a 50% reduction in total morphine consumption on the second postoperative day compared to those who received spinal anesthesia alone. Carli et al. (2010) found that patients who received femoral nerve blocks used less postoperative patient-controlled analgesia (PCA) and had better postoperative motor function recovery compared to those who received periarticular anesthetic infiltration.
Currently, there are various types of nerve block techniques, including femoral nerve, obturator nerve, adductor canal nerve, and sciatic nerve blocks. Different nerve block techniques result in varying analgesic efficacy, duration, functional impact, motor block, and complications. Sharma et al. (2010) indicated that femoral nerve blocks might cause quadriceps muscle weakness and patient falls. Kinghorn et al. (2012) also reported that sciatic nerve blocks might result in foot drop.
Study Design: This study is a retrospective analysis using the accumulated clinical database from 2017/09-2023/12 to analyze patients who underwent total knee arthroplasty and received nerve blocks. The aim is to compare the analgesic effects, incidence of nerve injury, and rate of chronic pain under different nerve block techniques.
Methods: A. Evaluation Methods: Data is collected in a patient registry called "acute pain service" (APS), which is the medical record for documenting the dose of patient controlled analgesia and side effects of PCA or nerve blocks.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 20 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient receiving general anesthesia combined with nerve blocks for total knee replacement
排除标准
- •Age less than 20 years old
- •Not receiving nerve blocks
- •American society of anesthesiologist physical status class greater than 4
- •Contraindicated to receiving nerve blocks
研究组 & 干预措施
Patient receiving Sciatic and Femoral nerve blocks
Patient receiving Sciatic and Femoral nerve blocks
干预措施: Femoral and sciatic nerve blocks (Procedure)
Patient receiving Adductor canal block and infiltration of posterior capsule of knee
Patient receiving Adductor canal block and infiltration of posterior capsule of knee
结局指标
主要结局
Acute postoperative pain
时间窗: Up to two days after surgery
Acute postoperative pain
次要结局
- Range of motion(Up to two days after surgery)
- Analgesic consumption(Up to two days after surgery)
- Ambulation time(Up to two days after surgery)
研究者
Sung, Chao-Hsien
Attending anesthesiologists
Fu Jen Catholic University Hospital
