Postoperative Pain Clinical Trial
Official title:
Effect of a Single Shot Sciatic Nerve Block (SNB) Combined With a Continuous Femoral Block (CFNB) on Pain Scores After Knee Arthroplasty. A Randomized Controlled Trial
The purpose of this study is to determine if the addition of a sciatic nerve block (SNB) to a continuous femoral nerve block (CFNB) improves post-operative analgesia after knee arthroplasty.
Background: Postoperative pain after total knee replacement /arthroplasty (TKA) is a major
concern. It is severe pain in 60% of patients and moderate in 30%. Continuous femoral nerve
blocks (CFNB) are considered an excellent choice for regional anesthesia for major knee
repair but there are some controversies about the need of supplemental obturator or sciatic
nerve blocks for achieving better postoperative analgesia. A recent meta-analysis states
there is no sufficient evidence to recommend or discharge these associations.
Objectives: We aim to assess the efficacy of the association of a sciatic nerve block (SNB)
and a continuous femoral nerve block (CFNB) for reducing postoperative pain in patients
submitted to TKA. Methods: A randomized controlled study on 50 patients submitted to TKA.
Control group receives a femoral nerve block with a catheter before general anesthesia is
induced and the intervention group gets a similar block plus a single shot SNB before
general anesthesia. Both groups start a continuous local anesthetic infusion through femoral
catheter after the end of surgery and supplemental oral diclofenac and paracetamol. Pain
scores are measured until 24h postoperatively, side effects and patient satisfaction are
monitored.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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