دورية أكاديمية
أعرض في EDS

Continuous femoral nerve blockade and single-shot sciatic nerve block promotes better analgesia and lower bleeding for total knee arthroplasty compared to intrathecal morphine: a randomized trial.

التفاصيل البيبلوغرافية
العنوان: Continuous femoral nerve blockade and single-shot sciatic nerve block promotes better analgesia and lower bleeding for total knee arthroplasty compared to intrathecal morphine: a randomized trial.
المؤلفون: Álvarez NER; Hospital das Clínicas, Divisão de Anestesia, Rua Dr. Ovídio Pires de Campos, 471, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010., Ledesma RJG; Hospital das Clínicas, Divisão de Anestesia, Rua Dr. Ovídio Pires de Campos, 471, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010., Hamaji A; Institute of Orthopedics and Trauma Surgery, Hospital das Clínicas, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010., Hamaji MWM; Institute of Orthopedics and Trauma Surgery, Hospital das Clínicas, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, CEP 05403-010., Vieira JE; Department of Surgery, University of São Paulo Medical School, Av. Dr. Arnaldo 455, sala 2345, Cerqueira César, São Paulo, SP, Brazil, CEP 01246-903. joaquimev@usp.br.
المصدر: BMC anesthesiology [BMC Anesthesiol] 2017 May 12; Vol. 17 (1), pp. 64. Date of Electronic Publication: 2017 May 12.
نوع المنشور: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2001-
مواضيع طبية MeSH: Arthroplasty, Replacement, Knee* , Femoral Nerve* , Nerve Block* , Sciatic Nerve*, Pain, Postoperative/*prevention & control , Postoperative Hemorrhage/*prevention & control, Aged ; Analgesics, Opioid/administration & dosage ; Anesthesia, Spinal ; Female ; Humans ; Injections, Spinal ; Male ; Middle Aged ; Morphine/administration & dosage ; Pain Measurement ; Prospective Studies
مستخلص: Background: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block.
Methods: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group). Pain score from verbal numeric rating scale (VNRS) and morphine consumption during the first 72 h, as well as motor blockade, adverse effects, and postoperative bleeding were recorded. Analysis of variance of repeated measures with Bonferroni post-test, t-test and Fisher exact test were used for statistical analysis.
Results: Thirty nine patients completed the study (M = 20; FI = 19 patients) and were similar except for higher age in the FI group. Motor blockade as well as movement pain during postanesthesia care unit (PACU) staying were not different between the groups, but movement pain was significantly lower in FI group after 24 h. Postoperative bleeding (ml) was lower in FI group.
Conclusions: Continuous femoral nerve block combined with sciatic nerve block provides effective for postoperative analgesia in patients undergoing total knee arthroplasty, with lower pain scores after 24 h and a lower incidence of adverse effects and bleeding compared to intrathecal morphine.
Trial Registration: Retrospectively registered on https://clinicaltrials.gov/ under identifier NCT02882152 , 23 rd December, 2016.
References: Anesthesiol Res Pract. 2012;2012:560879. (PMID: 22761615)
J Arthroplasty. 2013 Aug;28(7):1121-4. (PMID: 23265274)
Cochrane Database Syst Rev. 2016 Jan 05;(1):CD005059. (PMID: 26731032)
Can J Anaesth. 2016 May;63(5):552-68. (PMID: 26896282)
Acta Anaesthesiol Scand. 2009 Aug;53(7):914-20. (PMID: 19388886)
Pain Physician. 2016 May;19(4):205-14. (PMID: 27228509)
Reg Anesth Pain Med. 2011 Sep-Oct;36(5):489-92. (PMID: 21857276)
Anaesthesia. 2016 Oct;71(10):1198-209. (PMID: 27469381)
Arch Orthop Trauma Surg. 2016 Mar;136(3):397-406. (PMID: 26754752)
BMC Anesthesiol. 2015 Dec 15;15:182. (PMID: 26669859)
Eur Rev Med Pharmacol Sci. 2010 Jul;14(7):589-96. (PMID: 20707248)
Cochrane Database Syst Rev. 2014 May 13;(5):CD009941. (PMID: 24825360)
Anaesthesia. 2009 Jun;64(6):643-51. (PMID: 19462494)
Int J Surg. 2016 Aug;32:89-98. (PMID: 27370542)
J Knee Surg. 2016 Feb;29(2):169-78. (PMID: 25892004)
Anesthesiol Res Pract. 2014;2014:569319. (PMID: 25484894)
Reg Anesth Pain Med. 2011 Sep-Oct;36(5):493-8. (PMID: 21857266)
Anesth Analg. 1975 Jul-Aug;54(4):489-93. (PMID: 1170786)
Reg Anesth Pain Med. 2013 Nov-Dec;38(6):526-32. (PMID: 24121608)
Anesth Analg. 1994 Sep;79(3):495-500. (PMID: 8067554)
J Opioid Manag. 2012 May-Jun;8(3):177-92. (PMID: 22798178)
Curr Opin Anaesthesiol. 2014 Oct;27(5):501-6. (PMID: 25111605)
Eur Rev Med Pharmacol Sci. 2015 Apr;19(8):1489-97. (PMID: 25967725)
Eur J Anaesthesiol. 1998 Jan;15(1):6-9. (PMID: 9522133)
Rev Bras Anestesiol. 2010 Sep-Oct;60(5):495-512. (PMID: 20863930)
Anesth Analg. 2004 Nov;99(5):1539-43; table of contents. (PMID: 15502061)
Anesthesiology. 2014 Dec;121(6):1302-10. (PMID: 25099748)
Rev Assoc Med Bras (1992). 2015 Jan-Feb;61(1):40-3. (PMID: 25909207)
Reg Anesth Pain Med. 2005 Mar-Apr;30(2):128-33. (PMID: 15765454)
فهرسة مساهمة: Keywords: Analgesia; Anesthesia; Arthroplasty; Conduction; Knee; Nerve Block; Pain; Postoperative; Replacement
سلسلة جزيئية: ClinicalTrials.gov NCT02882152; NCT02882152
المشرفين على المادة: 0 (Analgesics, Opioid)
76I7G6D29C (Morphine)
تواريخ الأحداث: Date Created: 20170514 Date Completed: 20171107 Latest Revision: 20181113
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC5429542
DOI: 10.1186/s12871-017-0355-x
PMID: 28499420
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2253
DOI:10.1186/s12871-017-0355-x