Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks
IntroductionPeripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).MethodsThis prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1335405/full |
| _version_ | 1797357383200014336 |
|---|---|
| author | Svetlana Sreckovic Svetlana Sreckovic Nebojsa Ladjevic Nebojsa Ladjevic Biljana Milicic Biljana Milicic Goran Tulic Goran Tulic Darko Milovanovic Darko Milovanovic Marija Djukanovic Marija Djukanovic Marko Kadija Marko Kadija |
| author_facet | Svetlana Sreckovic Svetlana Sreckovic Nebojsa Ladjevic Nebojsa Ladjevic Biljana Milicic Biljana Milicic Goran Tulic Goran Tulic Darko Milovanovic Darko Milovanovic Marija Djukanovic Marija Djukanovic Marko Kadija Marko Kadija |
| author_sort | Svetlana Sreckovic |
| collection | DOAJ |
| description | IntroductionPeripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).MethodsThis prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks vs. no blocks) on opioid consumption, postoperative pain score, chronic post-surgical pain 2 years after TKA.Results166 patients (82 vs. 84) were analyzed. Opioid consumption was less in the group with blocks (9.74 ± 3.87 mg vs. 30.63 ± 11.52 mg) (p < 0.001). CPSP was present in 20.24% of patients in the group without blocks and 6.1% of patients with blocks (p = 0.011). Predictor variables of CPSP included pain before surgery (cut-off of 5.5), pain at rest (cut-off of 2.35), pain during active movement (cut-off: 2.5), and opioid consumption (cut-off: 8 mg).ConclusionPeripheral nerve blocks provide adequate analgesia, significantly decrease opioid consumption, improve functional outcomes, and reduce CPSP 2 years after surgery. |
| first_indexed | 2024-03-08T14:43:18Z |
| format | Article |
| id | doaj.art-cb8d1cac307d49bda2f72424dac82e95 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-08T14:43:18Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-cb8d1cac307d49bda2f72424dac82e952024-01-11T15:36:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.13354051335405Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocksSvetlana Sreckovic0Svetlana Sreckovic1Nebojsa Ladjevic2Nebojsa Ladjevic3Biljana Milicic4Biljana Milicic5Goran Tulic6Goran Tulic7Darko Milovanovic8Darko Milovanovic9Marija Djukanovic10Marija Djukanovic11Marko Kadija12Marko Kadija13Centre of Anaesthesia and Resuscitation, University Clinical Centre of Serbia, Belgrade, SerbiaClinic for Orthopaedics Surgery and Traumatology, University Clinical Centre of Serbia, Belgrade, SerbiaCentre of Anaesthesia and Resuscitation, University Clinical Centre of Serbia, Belgrade, SerbiaMedical School, University of Belgrade, Belgrade, SerbiaDepartment of Medical Statistics and Informatics, Belgrade, SerbiaSchool of Dental Medicine, University of Belgrade, Belgrade, SerbiaClinic for Orthopaedics Surgery and Traumatology, University Clinical Centre of Serbia, Belgrade, SerbiaMedical School, University of Belgrade, Belgrade, SerbiaClinic for Orthopaedics Surgery and Traumatology, University Clinical Centre of Serbia, Belgrade, SerbiaMedical School, University of Belgrade, Belgrade, SerbiaCentre of Anaesthesia and Resuscitation, University Clinical Centre of Serbia, Belgrade, SerbiaMedical School, University of Belgrade, Belgrade, SerbiaClinic for Orthopaedics Surgery and Traumatology, University Clinical Centre of Serbia, Belgrade, SerbiaMedical School, University of Belgrade, Belgrade, SerbiaIntroductionPeripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).MethodsThis prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks vs. no blocks) on opioid consumption, postoperative pain score, chronic post-surgical pain 2 years after TKA.Results166 patients (82 vs. 84) were analyzed. Opioid consumption was less in the group with blocks (9.74 ± 3.87 mg vs. 30.63 ± 11.52 mg) (p < 0.001). CPSP was present in 20.24% of patients in the group without blocks and 6.1% of patients with blocks (p = 0.011). Predictor variables of CPSP included pain before surgery (cut-off of 5.5), pain at rest (cut-off of 2.35), pain during active movement (cut-off: 2.5), and opioid consumption (cut-off: 8 mg).ConclusionPeripheral nerve blocks provide adequate analgesia, significantly decrease opioid consumption, improve functional outcomes, and reduce CPSP 2 years after surgery.https://www.frontiersin.org/articles/10.3389/fmed.2023.1335405/fullperipheral nerve blockchronic painadductor canal blockIPACK blockknee arthroplasty |
| spellingShingle | Svetlana Sreckovic Svetlana Sreckovic Nebojsa Ladjevic Nebojsa Ladjevic Biljana Milicic Biljana Milicic Goran Tulic Goran Tulic Darko Milovanovic Darko Milovanovic Marija Djukanovic Marija Djukanovic Marko Kadija Marko Kadija Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks Frontiers in Medicine peripheral nerve block chronic pain adductor canal block IPACK block knee arthroplasty |
| title | Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks |
| title_full | Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks |
| title_fullStr | Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks |
| title_full_unstemmed | Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks |
| title_short | Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks |
| title_sort | chronic post surgical pain after knee arthroplasty a role of peripheral nerve blocks |
| topic | peripheral nerve block chronic pain adductor canal block IPACK block knee arthroplasty |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1335405/full |
| work_keys_str_mv | AT svetlanasreckovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT svetlanasreckovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT nebojsaladjevic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT nebojsaladjevic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT biljanamilicic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT biljanamilicic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT gorantulic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT gorantulic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT darkomilovanovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT darkomilovanovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT marijadjukanovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT marijadjukanovic chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT markokadija chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks AT markokadija chronicpostsurgicalpainafterkneearthroplastyaroleofperipheralnerveblocks |