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Background and Aims This randomised controlled trial aims at comparing the efficacy of postoperative analgesia by USG guided single shot Femoro-sciatic block (FSB) with lumbar epidural block(EB) in patients of 14-60 years undergoing corrective orthopaedic procedures attributed to bone malignancy around the knee viz, distal end of femur and proximal end of tibia.
Methods METHODS 30 patients undergoing elective surgery for knee tumour resection and endoprosthesis placement for various bone mallignancies at
A.I.I.M.S. New delhi India were enrolled after approval of institute ethics committee & randomised to 2 groups as per intervention for postoperative analgesia viz Group E , receiving general anesthesia(GA) with EB and Group FS, receiving GA with ultrasound guided FSB. EB was performed with 0.25% Ropivacaine 10ml with 0.5mcg/kg Clonidine as adjuvant and FSB with 15 ml and 20ml of 0.25% ropivacaine with 0,5mcg/kg clonidine around femoral and sciatic nerve respectively. The primary outcome was quality of postoperative pain as assessed by VAS Score and total analgesic requirement in the first 24 hours postoperatively. The secondary outcomes were comparison of intraoperative hemodynamics,blood loss, incidence of adverse effects like PONV, pruritus, neurological sequelae, respiratory depression,& overall patient and surgeon satisfaction assessed.
Results RESULTS In FS Gp.VAS scores were better (p-value <0.001), consumed less fentanyl (186.7+/- 56.4mcg in Group FS and 277.33+/- 45.9 mcg in Group Ep<0.01)& provided prolonged pain relief . Secondary outcomes were comparable in both groups
Conclusions CONCLUSION USG FSB is superior to single shot lumbar EB in providing postoperative analgesia in knee tumour resection and endoprosthesis surgeries.
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