Femoral nerve block versus local infiltrative analgesia for postoperative pain after total knee arthroplasty

Abstract

Objective This prospective study compares the pain control after total knee replacement using a singleshot femoral nerve block (FNB) against local infi ltration analgesia (LIA). Patients and methods Sixty-four patients were included the study. A total of 29 patients received single-shot ultrasound-guided FNB at the end of the procedure, whereas 35 patients received LIA. Both groups were compared as regards pain at 2 and 4 h after surgery, pain before and after physical therapy on the fi rst postoperative day, early fl exion of the knee to 90°, total opiate use, and length of stay in the hospital. Results All patients completed the study. The group that received LIA showed signifi cantly less pain at 4 h postoperatively, on the fi rst postoperative day, and after physical therapy. The LIA group also showed signifi cantly better rehabilitation and less hospital stay. Patients who received FNB used signifi cantly more opiate compared with the LIA group. Conclusion LIA gives better pain control compared with single-shot FNB after total knee replacement.