Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction

Background and objectives: Knee anterior cruciate ligament reconstruction (ACLR) may be painful in the postoperative period. The primary objective of this study was to evaluate whether the use of femoral nerve block (FNB) associated with spinal anesthesia would improve the postoperative pain treatme...

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Main Authors: Úrsula Bueno do Prado Guirro, Elizabeth Milla Tambara, Fernanda Reinaldi Munhoz
Format: Article
Language:English
Published: Elsevier 2013-11-01
Series:Brazilian Journal of Anesthesiology
Online Access:http://www.sciencedirect.com/science/article/pii/S0104001413001139
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author Úrsula Bueno do Prado Guirro
Elizabeth Milla Tambara
Fernanda Reinaldi Munhoz
author_facet Úrsula Bueno do Prado Guirro
Elizabeth Milla Tambara
Fernanda Reinaldi Munhoz
author_sort Úrsula Bueno do Prado Guirro
collection DOAJ
description Background and objectives: Knee anterior cruciate ligament reconstruction (ACLR) may be painful in the postoperative period. The primary objective of this study was to evaluate whether the use of femoral nerve block (FNB) associated with spinal anesthesia would improve the postoperative pain treatment in ACLR and the secondary objectives were to evaluate tramadol request and adverse events. Method: 53 patients were randomly divided into two groups: GA (n =26) received spinal anesthesia and GB (n = 27) received spinal anesthesia and FNB. All patients received multimodal analgesia and rescue analgesics could be requested anytime. Assessments were performed at 6, 12 and 24 hours. Results: There was no difference between both groups regarding demographic and clinical- surgical variables. There was no difference between groups regarding pain intensity. Mean pain scores were higher at 12 hours in GA and there was no change in GB; 55.6% of patients reported moderate pain in GA and 53.8% mild pain in GB. There was no difference regarding tramadol request. There were no serious adverse events: 80.8% of patients in GB had motor block of the thigh and two fell. Conclusions: Analgesia was more effective with the combination of spinal and FNB, which allowed better control of postoperative pain, assessed 12 hours after anesthesia. There was no difference in tramadol request. Patients in this study had no serious adverse events; however, one must be attentive to motor paralysis and the possibility of falling when FNB is performed. Keywords: Postoperative analgesia, Femoral nerve block, Anterior cruciate ligament reconstruction, Spinal anesthesia, Tramadol, Adverse event
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spelling doaj.art-8baf7d3d803341afaff1606ab60092562022-12-22T03:37:49ZengElsevierBrazilian Journal of Anesthesiology0104-00142013-11-01636483491Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstructionÚrsula Bueno do Prado Guirro0Elizabeth Milla Tambara1Fernanda Reinaldi Munhoz2Post-Graduation Program in Surgery, Universidade Federal do Paraná, Curitiba, PR, Brazil; Service of Anesthesiology, Hospital do Trabalhador, Curitiba, PR, Brazil; Trate a Dor, Curitiba, PR, Brazil; Corresponding author.Discipline of Anesthesiology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil; Service of Anesthesiology, Hospital Santa Casa de Curitiba, Curitiba, PR, BrazilDepartment of Medical Residence, Hospital Santa Casa de Curitiba, Curitiba, PR, BrazilBackground and objectives: Knee anterior cruciate ligament reconstruction (ACLR) may be painful in the postoperative period. The primary objective of this study was to evaluate whether the use of femoral nerve block (FNB) associated with spinal anesthesia would improve the postoperative pain treatment in ACLR and the secondary objectives were to evaluate tramadol request and adverse events. Method: 53 patients were randomly divided into two groups: GA (n =26) received spinal anesthesia and GB (n = 27) received spinal anesthesia and FNB. All patients received multimodal analgesia and rescue analgesics could be requested anytime. Assessments were performed at 6, 12 and 24 hours. Results: There was no difference between both groups regarding demographic and clinical- surgical variables. There was no difference between groups regarding pain intensity. Mean pain scores were higher at 12 hours in GA and there was no change in GB; 55.6% of patients reported moderate pain in GA and 53.8% mild pain in GB. There was no difference regarding tramadol request. There were no serious adverse events: 80.8% of patients in GB had motor block of the thigh and two fell. Conclusions: Analgesia was more effective with the combination of spinal and FNB, which allowed better control of postoperative pain, assessed 12 hours after anesthesia. There was no difference in tramadol request. Patients in this study had no serious adverse events; however, one must be attentive to motor paralysis and the possibility of falling when FNB is performed. Keywords: Postoperative analgesia, Femoral nerve block, Anterior cruciate ligament reconstruction, Spinal anesthesia, Tramadol, Adverse eventhttp://www.sciencedirect.com/science/article/pii/S0104001413001139
spellingShingle Úrsula Bueno do Prado Guirro
Elizabeth Milla Tambara
Fernanda Reinaldi Munhoz
Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
Brazilian Journal of Anesthesiology
title Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
title_full Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
title_fullStr Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
title_full_unstemmed Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
title_short Femoral nerve block: assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
title_sort femoral nerve block assessment of postoperative analgesia in arthroscopic anterior cruciate ligament reconstruction
url http://www.sciencedirect.com/science/article/pii/S0104001413001139
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