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Total Diz Artroplasti Operasyonlarında Kombine Spinal Epidural Anestezi ile Ultrason Eşliğinde Femoral Sinir Blokajı Karşılaştırılması

Year 2018, Volume: 4 Issue: 3, 256 - 261, 01.01.2018

Abstract

Amaç: Çalışmada, total diz artroplastisi TDA cerrahisi uygulanan hastalarda kombine spinal epidural anestezi KSEA ile ultrasonografi eşliğinde femoral sinir blokajı FSB uygulamasının postoperatif erken dönem 48 saat ağrı skorları ve komplikasyonlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Retrospektif çalışmaya, Mayıs 2016-Mayıs 2017 tarihleri arasındaki elektif tek taraflı total diz artroplasti için KSEA Grup KSEA ile FSB Grup FSB uygulanan 302 hasta dahil edildi. Hastaların postoperatif dinlenme ve harekette görsel analog skala VAS ile ağrı skorları 30.dk, 2, 6, 12, 24 ve 48. saat hasta kontrollü analjezi HKA cihazı ile tüketilen toplam morfin miktarı ve komplikasyonlar 48. saatte değerlendirildi. Bulgular: Hastaların demografik özellikleri benzer bulundu p>0.05 . Her iki grubun zamana göre dinlenme ve hareket halindeki VAS skorları arasında anlamlı fark görülmedi p>0.05 . Gruplar arasında komplikasyonlar da ise anlamlı fark bulundu p

References

  • Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: Severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res 2011;97(2):139-44.
  • Hamilton TW, Strickland LH, Pandit HG. A meta- analysis on the use of gabapentinoids for the treatment of acute postoperative pain following total knee arthroplasty. J Bone Joint Surg Am 2016;98(16):1340-50.
  • Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: A prospective randomized study. J Arthroplasty 2007;22(6 Suppl 2):33-8.
  • Bozkurt M, Yilmazlar A, Faruk Bilgen OF. Comparing the effects of analgesia techniques with controlled intravenous and epidural on postoperative pain and knee rehabilitation after total knee arthroplasty. Joint Diseases and Related Surgery 2009;20(2):64-70.
  • Cip J, Erb-Linzmeier H, Stadlbauer P, et al. Continuous intra-articular local anesthetic drug instillation versus discontinuous sciatic nerve block after total knee arthroplasty. J Clin Anesth 2016;35:543-50.
  • Green L, Machin SJ. Managing anticoagulated patients during neuraxial anaesthesia. Br J Haematol 2010;149(2):195-208.
  • Howell SJ, Sear YM, Yeates D, Goldacre M, Sear JW, Foex P. Risk factors for cardiovascular death after elective surgery under general anaesthesia. Br J Anaesth 1998;80(1):14-9.
  • Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004;101(4):950-9.
  • Kovalak E, Doğan AT, Üzümcügil O, Obut A, Yıldız AS, Kanay E, Tüzüner T, Özyuvacı E. A comparison of continuous femoral nerve block and periarticular local infiltration analgesia in the management of early period pain developing after total knee arthroplasty. Acta Orthop Traumatol Turc 2015;49(3):260-6.
  • Strassels SA, Chen C, Carr DB. Postoperative analgesia: Economics, resource use, and patient satisfaction in an urban teaching hospital. Anesth Analg 2002;94(1):130-7.
  • Scranton PE Jr. Management of knee pain and stiffness after total knee arthroplasty. J Arthroplasty 2001;16(4):428- 35.
  • Rawal N, Van Zundert A, Holmstrom B, Crowhurst JA. Combined spinal-epidural technique. Reg Anesth 1997;22(5):406-23.
  • Nakagawa S, Arai Y, Inoue H, Kan H, Hino M, Ichimaru S, Ikoma K, Fujiwara H, Amaya F, Sawa T, Kubo T. Comparative effects of periarticular multimodal drug injection and single-shot femoral nerve block on pain following total knee arthroplasty and factors influencing their effectiveness. Knee Surg Relat Res 2016;28(3):233-8.
  • Chia N, Low TC, Poon KH. Peripheral nerve blocks for lower limb surgery-a choice anaesthetic technique for patients with a recent myocardial infarction? Singapore Med J 2002;43(11):583-6.
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology 2012;116(2): 248-73.
  • Allen HW, Liu SS, Ware PD, Nairn CS, Owens BD. Anesth Analg 1998;87(1):93-7.
  • Wang H, Boctor B, Verner J. The effect of single-injection femoral nerve block on rehabilitation and length of hospital stay after total knee replacement. Reg Anesth Pain Med 2002;27:139-44.
  • Mulroy MF, Larkin KL, Batra MS, Hodgson PS, Owens BD. Femoral nerve block with 0.25% or 0.5% bupivacaine improves postoperative analgesia following outpatient arthroscopic anterior cruciate ligament repair. Reg Anesth Pain Med 2001;26:24-9.
  • Sundarathiti P, Ruananukul N, Channum T, Kitkunasathean C, Mantay A, Thammasakulsiri J, Sodsee W. A comparison of continuous femoral nerve block (CFNB)and continuous epidural infusion (CEI) in postoperative analgesia and knee rehabilitation after total knee arthroplasty (TKA). J Med Assoc Thai 2009;92(3):328-34.
  • Hirst GC, Lang SA, Dust WN, Cassidy JD, Yip RW. Femoral nerve block. Single injection for total knee arthroplasy. Reg Anesth 1996;21:292-7.
  • 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;87:88 -92.
  • Viscusi ER, Parvizi J, Tarity TD. Developments in spinal and epidural anesthesia and nerve blocks for total joint arthroplasty: What is new and exciting in pain management. In: Marsh LJ, ed. Instructional course lectures, vol: 56. Rosemont (IL): American Academy of Orthopaedic Surgeons. Instr Course Lect 2007;56:139- 45.
  • Fowler SJ, Symons J, Sabato S, Myles PS. Epidural analgesia compared with peripheral nerve blockade after major knee surgery: A systematic review and meta-analysis of randomized trials. Br J Anaesth 2008;100(2):154-64.
  • 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 1999;91:8-15.
  • Imbelloni LE, Carneiro ANG. Bloqueio combinado raqui-peridural para cirurgias ortopédicas: Agulha de dupla luz em punção şnica ou duas agulhas em espaços diferentes. (Combined spinal-epidural anesthesia for orthopedic surgery: Needle-through needle technique or two needle in different interspaces). Rev Bras Anestesiol 1998;48(3):177-83.
  • Morgan EG, Mikhail SM. Clinical Anaesthesiology. 5th ed. Appleton and Lange, New York 2013;195.
  • Safa B, Gollish J, Haslam L, McCartney CJ. Comparing the effects of single shot sciatic nerve block versus posterior capsule local anesthetic infiltration on analgesia and functional outcome after total knee arthroplasty: A prospective, randomized, double-blinded, controlled trial. J Arthroplasty 2014;29(6):1149-53.
  • Loo CC, Dahlgren G, Irestedt L. Neurological complications in obstetric regional anaesthesia. Int J Obstet Anesth 2000;9(2):99-124.
  • Hadzic A, Vloka JD, Kuroda MM, et al. The practice of peripheral nerve blocks in the United States: A national survey. Reg Anaesth and Pain Med 1998;23(3):241-6.

Comparison of Ultrasound-Guided Femoral Nerve Block with Combined Spinal Epidural Anesthesia in Total Knee Arthroplasty

Year 2018, Volume: 4 Issue: 3, 256 - 261, 01.01.2018

Abstract

Objective: The objective of this study was to compare postoperative early 48 hours visual analogue scale VAS scores following combined spinal epidural anesthesia CSEA and ultrasound-guided femoral nerve block FNB in patients undergoing total knee arthroplasty TKA .Material and Methods: This retrospective study included 302 patients who underwent CSEA Group CSEA and FNB Group FNB for elective unilateral total knee arthroplasty between May 2016 and May 2017. Postoperative Visual analogue scale VAS scores at rest and during activity 30th min, 2, 6, 12, 24 and 48th hours , the total amount of morphine consumed 48th hour by the patient controlled analgesia PCA device, and the complications were evaluated.Results: The demographic characteristics of the patients were similar p>0.05 . There was no statistically significant difference between the two groups in terms of resting and active VAS scores according to timepoints p>0.05 . However, there was a significant difference in complications hypotension, nausea and vomiting, neurological damage, respiratory depression, pruritus between the two groups p

References

  • Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: Severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res 2011;97(2):139-44.
  • Hamilton TW, Strickland LH, Pandit HG. A meta- analysis on the use of gabapentinoids for the treatment of acute postoperative pain following total knee arthroplasty. J Bone Joint Surg Am 2016;98(16):1340-50.
  • Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: A prospective randomized study. J Arthroplasty 2007;22(6 Suppl 2):33-8.
  • Bozkurt M, Yilmazlar A, Faruk Bilgen OF. Comparing the effects of analgesia techniques with controlled intravenous and epidural on postoperative pain and knee rehabilitation after total knee arthroplasty. Joint Diseases and Related Surgery 2009;20(2):64-70.
  • Cip J, Erb-Linzmeier H, Stadlbauer P, et al. Continuous intra-articular local anesthetic drug instillation versus discontinuous sciatic nerve block after total knee arthroplasty. J Clin Anesth 2016;35:543-50.
  • Green L, Machin SJ. Managing anticoagulated patients during neuraxial anaesthesia. Br J Haematol 2010;149(2):195-208.
  • Howell SJ, Sear YM, Yeates D, Goldacre M, Sear JW, Foex P. Risk factors for cardiovascular death after elective surgery under general anaesthesia. Br J Anaesth 1998;80(1):14-9.
  • Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004;101(4):950-9.
  • Kovalak E, Doğan AT, Üzümcügil O, Obut A, Yıldız AS, Kanay E, Tüzüner T, Özyuvacı E. A comparison of continuous femoral nerve block and periarticular local infiltration analgesia in the management of early period pain developing after total knee arthroplasty. Acta Orthop Traumatol Turc 2015;49(3):260-6.
  • Strassels SA, Chen C, Carr DB. Postoperative analgesia: Economics, resource use, and patient satisfaction in an urban teaching hospital. Anesth Analg 2002;94(1):130-7.
  • Scranton PE Jr. Management of knee pain and stiffness after total knee arthroplasty. J Arthroplasty 2001;16(4):428- 35.
  • Rawal N, Van Zundert A, Holmstrom B, Crowhurst JA. Combined spinal-epidural technique. Reg Anesth 1997;22(5):406-23.
  • Nakagawa S, Arai Y, Inoue H, Kan H, Hino M, Ichimaru S, Ikoma K, Fujiwara H, Amaya F, Sawa T, Kubo T. Comparative effects of periarticular multimodal drug injection and single-shot femoral nerve block on pain following total knee arthroplasty and factors influencing their effectiveness. Knee Surg Relat Res 2016;28(3):233-8.
  • Chia N, Low TC, Poon KH. Peripheral nerve blocks for lower limb surgery-a choice anaesthetic technique for patients with a recent myocardial infarction? Singapore Med J 2002;43(11):583-6.
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology 2012;116(2): 248-73.
  • Allen HW, Liu SS, Ware PD, Nairn CS, Owens BD. Anesth Analg 1998;87(1):93-7.
  • Wang H, Boctor B, Verner J. The effect of single-injection femoral nerve block on rehabilitation and length of hospital stay after total knee replacement. Reg Anesth Pain Med 2002;27:139-44.
  • Mulroy MF, Larkin KL, Batra MS, Hodgson PS, Owens BD. Femoral nerve block with 0.25% or 0.5% bupivacaine improves postoperative analgesia following outpatient arthroscopic anterior cruciate ligament repair. Reg Anesth Pain Med 2001;26:24-9.
  • Sundarathiti P, Ruananukul N, Channum T, Kitkunasathean C, Mantay A, Thammasakulsiri J, Sodsee W. A comparison of continuous femoral nerve block (CFNB)and continuous epidural infusion (CEI) in postoperative analgesia and knee rehabilitation after total knee arthroplasty (TKA). J Med Assoc Thai 2009;92(3):328-34.
  • Hirst GC, Lang SA, Dust WN, Cassidy JD, Yip RW. Femoral nerve block. Single injection for total knee arthroplasy. Reg Anesth 1996;21:292-7.
  • 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;87:88 -92.
  • Viscusi ER, Parvizi J, Tarity TD. Developments in spinal and epidural anesthesia and nerve blocks for total joint arthroplasty: What is new and exciting in pain management. In: Marsh LJ, ed. Instructional course lectures, vol: 56. Rosemont (IL): American Academy of Orthopaedic Surgeons. Instr Course Lect 2007;56:139- 45.
  • Fowler SJ, Symons J, Sabato S, Myles PS. Epidural analgesia compared with peripheral nerve blockade after major knee surgery: A systematic review and meta-analysis of randomized trials. Br J Anaesth 2008;100(2):154-64.
  • 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 1999;91:8-15.
  • Imbelloni LE, Carneiro ANG. Bloqueio combinado raqui-peridural para cirurgias ortopédicas: Agulha de dupla luz em punção şnica ou duas agulhas em espaços diferentes. (Combined spinal-epidural anesthesia for orthopedic surgery: Needle-through needle technique or two needle in different interspaces). Rev Bras Anestesiol 1998;48(3):177-83.
  • Morgan EG, Mikhail SM. Clinical Anaesthesiology. 5th ed. Appleton and Lange, New York 2013;195.
  • Safa B, Gollish J, Haslam L, McCartney CJ. Comparing the effects of single shot sciatic nerve block versus posterior capsule local anesthetic infiltration on analgesia and functional outcome after total knee arthroplasty: A prospective, randomized, double-blinded, controlled trial. J Arthroplasty 2014;29(6):1149-53.
  • Loo CC, Dahlgren G, Irestedt L. Neurological complications in obstetric regional anaesthesia. Int J Obstet Anesth 2000;9(2):99-124.
  • Hadzic A, Vloka JD, Kuroda MM, et al. The practice of peripheral nerve blocks in the United States: A national survey. Reg Anaesth and Pain Med 1998;23(3):241-6.
There are 29 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Faruk Çiçekci This is me

Ahmet Yıldırım This is me

Özkan Önal This is me

Ömer Faruk Erkoçak This is me

Jale Bengi Çelik This is me

İnci Kara This is me

Publication Date January 1, 2018
Published in Issue Year 2018 Volume: 4 Issue: 3

Cite

APA Çiçekci, F., Yıldırım, A., Önal, Ö., Erkoçak, Ö. F., et al. (2018). Comparison of Ultrasound-Guided Femoral Nerve Block with Combined Spinal Epidural Anesthesia in Total Knee Arthroplasty. Akdeniz Tıp Dergisi, 4(3), 256-261.