Post-operative analgesia following total knee arthroplasty: Comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: A randomized, single blinded, controlled study

European Review for Medical and Pharmacological Sciences

Volumn 14, Issue 7, 2010, Pages 589-596

  Frassanito, Luciano ^a   Vergari, A ^a   Zanghi, F ^a   Messina, A ^a   Bitondo, M ^a   Antonelli, M ^a  

^a CATHOLIC UNIVERSITY   (Italy)

Author keywords

Femoral nerve block; Intrathecal morphine; Knee arthroplasty; Postoperative analgesia

Indexed keywords

ANTIEMETIC AGENT; ANTIPRURITIC AGENT; BUPIVACAINE; ENOXAPARIN; KETOROLAC; MORPHINE; MORPHINE SULFATE; ONDANSETRON; OPIATE; PARACETAMOL; REMIFENTANIL; ROPIVACAINE; AMIDE; LOCAL ANESTHETIC AGENT; NARCOTIC ANALGESIC AGENT;

ADULT; AGED; ARTICLE; BOLUS INJECTION; CONTROLLED STUDY; DEEP VEIN THROMBOSIS; DRUG DOSE COMPARISON; DRUG EFFICACY; DRUG SAFETY; DRUG USE; FEMALE; FEMORAL NERVE BLOCK; HUMAN; KNEE OSTEOARTHRITIS; LOW DRUG DOSE; LUMBAR PUNCTURE; LUMBAR VERTEBRA; MAJOR CLINICAL STUDY; MALE; NAUSEA; NERVE BLOCK; PAIN ASSESSMENT; PATIENT CONTROLLED ANALGESIA; POSTOPERATIVE ANALGESIA; POSTOPERATIVE NAUSEA AND VOMITING; POSTOPERATIVE PAIN; PRURITUS; RANDOMIZED CONTROLLED TRIAL; RESPIRATION DEPRESSION; SINGLE BLIND PROCEDURE; SPINE; SUBARACHNOID PUNCTURE; TOTAL KNEE REPLACEMENT; TREATMENT OUTCOME; ULTRASOUND; VISUAL ANALOG SCALE; VOMITING; ANALYSIS OF VARIANCE; CLINICAL TRIAL; COMPARATIVE STUDY; CONTROLLED CLINICAL TRIAL; FEMORAL NERVE; KNEE ARTHROPLASTY; METHODOLOGY; MIDDLE AGED;

AGED; AMIDES; ANALGESIA, PATIENT-CONTROLLED; ANALGESICS, OPIOID; ANALYSIS OF VARIANCE; ANESTHETICS, LOCAL; ARTHROPLASTY, REPLACEMENT, KNEE; BUPIVACAINE; FEMALE; FEMORAL NERVE; HUMANS; MALE; MIDDLE AGED; MORPHINE; NERVE BLOCK; PAIN MEASUREMENT; PAIN, POSTOPERATIVE; SINGLE-BLIND METHOD;

EID: 77955946638     PISSN: 11283602     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (27)

1. CAPDEVILA X, BARTHELET Y, BIBOULET P, RYCKWAERT Y, RUBENOVITCH J, D'ATHIS F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology 1999; 91: 8-15.
2. SINGELYN FJ, DEYAERT M, JORIS D, PENDEVILLE E, GOUVERNEUR JM. Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth Analg 1998; 87: 88-92.
3. FRASSANITO L, VERGARI A, MESSINA A, PITONI S, PUGLISI C, CHIERICHINI A. Anaesthesia for total knee arthroplasty: efficacy of single-injection or continuous lumbar plexus associated with sciatic nerve blocks-a randomized controlled study. Eur Rev Med Pharmacol Sci 2009; 13: 375-382.
4. RANAWAT AS, RANAWAT CS. Pain management and accelerated rehabilitation for total hip and total knee arthroplasty. J Arthroplasty 2007; 22(7 Suppl 3): 12-15.
5. CHOI PT, BHANDARI M, SCOTT J, DOUKETIS J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev 2003(3): CD003071.
6. FISCHER HB, SIMANSKI CJ, SHARP C, BONNET F, CAMU F, NEUGEBAUER EA, RAWAL N, JOSHI GP, SCHUG SA, KEHLET H; PROSPECT WORKING GROUP. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia 2008; 63: 1105-1123.
7. RATHMELL JP, PINO CA, TAYLOR R, PATRIN T, VIANI BA. Intrathecal morphine for postoperative analgesia: a randomized, controlled, dose-ranging study after hip and knee arthroplasty. Anesth Analg 2003; 97: 1452-1457.
8. TZIAVRANGOS E, SCHUG SA. Regional anaesthesia and perioperative outcome. Curr Opin Anaesthesiol 2006; 19: 521-525.
9. WAGNER KJ, KOCHS EF, KRAUTHEIM V, GERDESMEYER L. Perioperative pain therapy for knee endoprosthetics. Orthopade 2006; 35: 153-161.
10. RODGERS A, WALKER N, SCHUG S, MCKEE A, KEHLET H, VAN ZUNDERT A, SAGE D, FUTTER M, SAVILLE G, CLARK T, MACMAHON S. Reduction of postoperative mortality and morbidity with epidural OR spinal anaesthesia: results from overview of randomised trials. Br Med J 2000; 321(7275): 1493.
11. DE RUYTER ML, BRUEILLY KE, HARRISON BA, GREENGRASS RA, PUTZKE JD, BRODERSEN MP. A pilot study on continuous femoral perineural catheter for analgesia after total knee arthroplasty: the effect on physical rehabilitation and outcomes. J Arthroplasty 2006; 21: 1111-1117.
12. BONICA JJ. Current status of postoperative pain therapy. In: Yokota T. DR, ed. Current topics in pain research and therapy. Vol 78. Amsterdam-Oxford-Princeton: Excerpta Medica; 1983:606-617.
13. KEHLET H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 1997; 78: 606-617.
14. ALLEN HW, LIU SS, WARE PD, NAIRN CS, OWENS BD. Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesth Analg 1998; 87: 93-97.
15. ILFELD BM, MEYER RS, LE LT, MARIANO ER, WILLIAMS BA, VANDENBORNE K, DUNCAN PW, SESSLER DI, ENNEKING FK, SHUSTER JJ, MALDONADO RC, GEAREN PF. Health-related quality of life after tricompartment knee arthroplasty with and without an extendedduration continuous femoral nerve block: a prospective, 1-year follow-up of a randomized, triple-masked, placebo-controlled study. Anesth Analg 2009; 108: 1320-1325.
16. MARHOFER P, SCHROGENDORFER K, KOINIG H, KAPRAL S, WEINSTABL C, MAYER N. Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks. Anesth Analg 1997; 85: 854-857.
17. MARHOFER P, SCHROGENDORFER K, WALLNER T, KOINIG H, MAYER N, KAPRAL S. Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks. Reg Anesth Pain Med 1998; 23: 584-588.
18. GEHLING M, TRYBA M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia 2009; 64: 643-651.
19. GEHLING MH, LUESEBRINK T, KULKA PJ, TRYBA M. The effective duration of analgesia after intrathecal morphine in patients without additional opioid analgesia: a randomized double-blind multicentre study on orthopaedic patients. Eur J Anaesthesiol 2009; 26: 683-688.
20. GEHLING M, TRYBA M, LUESEBRINK T, ZORN A. Can the addition of clonidine improve the analgesic efficacy of low dose intrathecal morphine? A randomised double-blind trial. Anaesthesist 2003; 52: 204-209.
21. MURPHY PM, STACK D, KINIRONS B, LAFFEY JG. Optimizing the dose of intrathecal morphine in older patients undergoing hip arthroplasty. Anesth Analg 2003; 97: 1709-1715.
22. FRASSANITO L, RODOLÀ F, CONCINA G, MESSINA A, CHIERICHINI A, VERGARI A. The efficacy of the psoas compartment block versus the intrathecal combination of morphine, fentanyl and bupivacaine for postoperative analgesia after primary hip arthroplasty: a randomized single-blinded study. Eur Rev Med Pharmacol Sci 2008; 12: 117-122.
23. HORLOCKER TT, KOPP SL, PAGNANO MW, HEBL JR. Analgesia for total hip and knee arthroplasty: a multimodal pathway featuring peripheral nerve block. J Am Acad Orthop Surg 2006; 14: 126-135.
24. HYNES D, MCCARROLL M, HIESSE-PROVOST O. Analgesic efficacy of parenteral paracetamol (propacetamol) and diclofenac in post-operative orthopaedic pain. Acta Anaesthesiol Scand 2006; 50: 374-381.
25. FOWLER SJ, SYMONS J, SABATO S, MYLES PS. Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta-analysis of randomized trials. Br J Anaesth 2008; 100: 154-164.
26. TARKKILA P, TUOMINEN M, HUHTALA J, LINDGREN L. Comparison of intrathecal morphine and continuous femoral 3-in-1 block for pain after major knee surgery under spinal anaesthesia. Eur J Anaesthesiol 1998; 15: 6-9.
27. SITES BD, BEACH M, GALLAGHER JD, JARRETT RA, SPARKS MB, LUNDBERG CJ. A single injection ultrasound-assisted femoral nerve block provides side effectsparing analgesia when compared with intrathecal morphine in patients undergoing total knee arthroplasty. Anesth Analg 2004; 99: 1539-1543.