CLINICAL OBSERVATION OF CONTINUOUS FEMORAL NERVE BLOCK FOR POSTOPERATIVE REHABILITATION PAIN AFTER TOTAL KNEE ARTHROPLASTIC SURGERY

Objective: To observe the effect of continuous femoral nerve block on postoperative rehabilitation pain after total knee arthroplasty (TKA). Methods: Thirty patients, ASA I~II , undergoing unilateral TKA surgery, were randomly divided into two groups: group FA and group IA. All patients received general anesthesia with tracheal intubation. After operation, patients were given nerve-blocked analgesia with 0.5 % hydrochloric acid lidocaine injected through a catheter in group FA (15ml, 2~6 h/prn) and continuous intravenous analgesia with tramadol in group IA. All patients were maintained analgesia for 3 days. VAS pain scores during rest, initiative exercise and continuous passive movement (CPM), time of first walk, Rameasay sedation scores, muscle strength grades and complications were recorded. Results: The VAS pain scores during rest, initiative exercise and CPM at all time points except postoperative 1h in group FA were significantly lower than those in group IA. There was no significant difference about the time of first walk between two groups [(27±4)h vs(25±2)h]. In general, it was satisfactory about sedation degree in two groups. Average muscle strength grades during postoperative 24~72h in two groups were above grade 3. Compared with group IA, a significantly lower incidence of side effects was noted in group FA(4 vs 12,P=0.009). Conclusion: After TKA surgery, the continuous femoral nerve block can provide better pain relief, slight impact on muscle strength of lower limb and fewer side effects. Therefore, it could be the choice for postoperative rehabilitation analgesia.