Femoral Nerve Block for Pain Control after Total Knee Surgery

Background: Pain control after total knee arthroplasty (TKR) surgery is important for patients’ recovery, early start of physiotherapy, reducing hospital length of stay reduced risk of thromboembolism and for patients satisfaction.

Optimal postoperative analgesia leads to early mobilization, ambulation, and return to a normalized gait pattern. Decrease adverse side effects of narcotics ,nausea, vomiting, hypotension, respiratory depression, and constipation, and confusion.Femoral nerve block gain popularity either as single injection or continuous infusion (24 - 72 hours) with catheter, in controlling pain after TKR

Methods: We retrospectively analyses the results of patients after TKR that had femoral block and compared them to results of patients not having femoral nerve block.(FNB) We hypothesized patients with FNB after TKA will show decreased length of stay, decreased number of postoperative complications, accelerated rehabilitation, earlier range-of-motion, earlier mobilization than patients not receiving femoral nerve block.

Results: We compared the medical records of 68 patients. 37 of them had FNB. 31 did not get a femoral block. 34 had Left TKR, 34 RightTKR. 24 patients had general anesthesia and 44 had Spinal anesthesia Patients with FNB got statistical significant les morphine in the first 12 hours after surgery. There was no difference in range of motion or walking distance between groups. 25% of FNB had collapse of their knee in the first day after surgery, with less patients in the FNB reporting feeling independence in walking during their hospitalization.

Conclusion: FNB patients did not have a better recovery than patients without block, and had more collapse while doing rehabilitation.