Comparison of Analgesic Effects of Continuous Femoral Nerve Block, Femoral Triangle Block, and Adductor Block After Total Knee Arthroplasty

作者全名：Tan, Minghe; Chen, Bozhou; Li, Qingshu; Wang, Siqi; Chen, Daiyu; Zhao, Maoji; Cao, Jun

作者地址：[Tan, Minghe; Chen, Bozhou; Wang, Siqi; Chen, Daiyu; Zhao, Maoji; Cao, Jun] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China; [Li, Qingshu] Chongqing Med Univ, Coll Basic Med, Dept Pathol, Chongqing, Peoples R China

通信作者：Cao, J (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Yixueyuan Rd, Chongqing 400016, Peoples R China.

来源：CLINICAL JOURNAL OF PAIN

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001217559000001

JCR分区：Q2

影响因子：2.6

年份：2024

卷号：40

期号：6

开始页：373

结束页：382

文献类型：Article

关键词：total knee arthroplasty; analgesic effects; nerve blocks; postoperative pain; quadriceps strength

摘要：Objectives:This study aimed to compare the analgesic effects of continuous femoral nerve block (FNB), femoral triangle block (FTB), and adductor canal block (ACB) following total knee arthroplasty (TKA). The goal was to identify the most effective nerve block technique among these.Methods:Patients undergoing TKA were randomly assigned to 1 of 3 groups: FNB, FTB, or ACB. Nerve blocks were administered preoperatively, with catheters placed for patient-controlled nerve analgesia (PCNA). The primary end point was the Numeric Rating Scale (NRS) score at movement at 24 hours postsurgery. Secondary end points included NRS scores at rest and movement, quadriceps strength, Timed Up and Go (TUG) test performance, range of motion, effective PCNA utilization, and opioid consumption at various postsurgery time points.Results:Of the 94 valid data sets analyzed (FNB: 31, FTB: 31, ACB: 32), significant differences were observed in the primary end point (H=7.003, P=0.03). Post hoc analysis with Bonferroni correction showed that the FNB group had a significantly lower median pain score (3 [2 to 4]) compared with the ACB group (4 [3 to 5], Bonferroni-adjusted P=0.03). Regarding secondary end points, both the FNB and FTB groups had significantly lower NRS scores than the ACB group at various time points after surgery. Quadriceps strength and TUG completion were better in the FTB and ACB groups. There were no statistically significant differences among the groups for the other end points.Discussion:Continuous FTB provides postoperative analgesia comparable to FNB but with the advantage of significantly less impact on quadriceps muscle strength, a benefit not seen with FNB. Both FTB and ACB are effective in preserving quadriceps strength postoperatively.

基金机构：Department of Orthopedics-Joint Surgery, Nursing and Rehabilitation Team of the First Affiliated Hospital of Chongqing Medical University

基金资助正文：The authors thank the Department of Orthopedics-Joint Surgery, Nursing and Rehabilitation Team of the First Affiliated Hospital of Chongqing Medical University for their help during the trial.