Background and aims This prospective study of long-term outcomes regarding postoperative pain and early mobilization refers to patients undergoing total knee arthroplasty (TKA). We compared an intravenous postoperative analgesia, with peripheral nerve blockade. The aim of our study is to find the optimal analgesic method for such patients in our hospital conditions.

Methods 150 patients ASA II after TKA were followed. Ethical committee approval was obtained. Patients were previously randomized and divided into three groups: group A(n=54) received preoperative blockade (ultrasound-guided) of sciatic nerve and adductor canal catheter, group B (n=42) received only spinal anesthesia, followed by intravenous postoperative analgesia at the ward, group C (n=54) received preoperative blockade of sciatic nerve and femoral nerve catheter. All patients received spinal anesthesia for surgery. Intraoperative and postoperative pain was measured in the first 24 hours using visual analogue scale (VAS), as well as use of intravenous analgetics, postoperative nausea, muscle weakness, foot flexion and patient satisfaction score.

Results Intraoperative VAS was similar in all groups. Postoperative VAS was lower in groups A and C compared to group B. There is a statistical difference between groups A and C in quadriceps muscle weakness. Foot flexion was slightly longer in group C. Postoperative nausea was found in group B. Patient satisfaction scores were similar in all groups.

Conclusions Patients undergoing TKA suffer from long-standing pain and impaired physical functioning. They have a high risk for chronic pain. Pain treatment should start preoperatively by peripheral nerve blockade and continuously through the nerve catheter. Those patients had lower pain scores and better functional recovery.