Background and Aims Total knee arthroplasty (TKA) improves mobility and quality of life but is followed by severe to moderate pain postoperatively [1–2]. Blocking anterior femoral nerve branches (AFNB) in combination with femoral triangle (FT) and adductor canal (AC) is considered to help withearly ambulation and overall patient’s satisfaction . We aimed to compare pain and functional recovery in patients who underwent TKA.
Methods Bioethics Centre at LUHS approved the study (BEC-MF-291). Patients undergoing TKA were included in this prospective, double-blind study and randomised into two groups. Group A (A) contained 21 patients undergoing proximal FT (pFT), distal AC (dAC) and AFNB block, and group B (B) 19 patients undergoing distal FT (dFT) and dAC block. Pain according to VAS, opioid consumption, extent of motor block (Bromage scale) were assessed after 3, 6, 24 and 48 hours and ability of early ambulation (Timed Up and Go (TUG) test) - 24 and 48 hours after the surgery.
Results 40 patients were tested, 12 (30%) men and 28 (70%) women, mean age 65.73 (8.65) years. Demographics did not differ statistically significantly (p>0.05). There was no difference in VAS scores and Bromage scale between groups. Opioid consumption after 6 hours was statistically significantly lower in A than B with 1 (4.8%) and 6 (31.6%) patients, respectively (p=0.039). TUG test took slightly shorter in A than B after 24 and 48 hours, but was statistically insignificant (p>0.05).
Conclusions Statistically significantly lower opioid consumption proved that AFNB block improves FT and AC block. Further research with larger samples is needed.
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