Multimodal neural block analgesia versus morphine analgesia after elective knee surgery
Journal Title: Scripta Medica (Banja Luka) - Year 2019, Vol 50, Issue 3
Abstract
Background: Total knee arthroplasty has become a standard for treatment of endstage knee osteoarthritis. Due to intense and complex knee innervation, there is a need to improve the anaesthetic/analgesic approach to such operations. The aim of this randomised clinical trial was to compare the analgesic efficacy of the classical regimen and two of those based on the nerve blocks. Methods: A total of 60 patients was included and subjected to elective total knee arthroplasty under the general balanced anaesthesia. They were randomised to receive postoperatively (1) only morphine 5-10 mg q6h and paracetamol 1 g q6h (MP), (2) femoral nerve block (FNB) or (3) fascia iliac compartment nerve block (FICNB). Nerve blocks were produced by a single administration of 30-40 ml of bupivacaine 0.5%. Pain intensity, duration of neural block and additional consumption of analgesics were recorded postoperatively. Results: There were no demographic differences among the three groups of patients. Pain intensity was significantly lower in the two nerve block groups than in the MP group. The same two groups also demanded significantly less analgesics postoperatively than the MP group. Cardiovascular control was significantly better in the nerve block groups. There were no significant differences between the FNB and FICNB groups of patients regarding any of the studied parameters. Conclusion: In comparison with the classical MP analgesia, use of FNB or FICNB after the elective total knee arthroplasty results in lower pain scores, lower systolic blood pressure and less consumption of analgesics in the immediate postoperative course.
Authors and Affiliations
Dragana Lončar-Stojiljković
Dermal regeneration with MilliGraft® kit of nanofat: the micrograft of adipose tissue. A clinical assessment study
The simple filtration by means of the MilliGraft ® Kit of a disaggregated lipoaspirate allows to extract the class of cells defined as progentors with characteristics of adult stem cells present in the nanofat exclusivel...
Effects of the radial extracorporeal shock wave therapy (rESWT) in patients with calcific tendinopathy of the shoulder
Introduction: Calcific tendinopathy (CT) of the shoulder is frequently a painful condition that is occurring when there are calcium deposits in the tendons of the rotator cuff. There are many options for treatment starti...
Surgical treatment of aortic valve fibroelastoma: a case report
A 45-year-old man was admitted to Clinic for the first time, with symptoms of chest pain and fatigue. Computerised tomography (CT) diagnostics of the chest showed a soft tissue vegetation of approximately 5x5 mm on the l...
Human papillomavirus infections in women with and without squamous cell abnormalities of the uterine cervix
Background: Human papillomavirus infections are one of the most common sexually transmitted infections with viral aetiology. The aim of the study was to confirm the existence of an association between human papillomaviru...
Renin-angiotensin and kallikrein-kinin systems in diabetic retinopathy
This brief review describes how two complex systems, the renin-angiotensin system (RAS) and the kallikrein-kinin system (KKS), affect the retina. It emphasises the important physiological actions of components of these s...