Izvorni znanstveni članak
Peripheral Regional Analgesia with Femoral Catheter versus Intravenous Patient Controlled Analgesia after Total Knee Arthroplasty: A Prospective Randomized Study
Senka Baranović
Branka Maldini
Milan Milošević
Rajna Golubić
Tatjana Nikolić
Sažetak
The aim of this study is to compare the effects of femoral analgesia (FA) with 0.25% levobupivacain and intravenous
patient controlled analgesia (PCA) with morphine on postoperative pain assessed by a visual-analog scale (VAS) score
and their complications during the first 24 postoperative hours after the a total knee arthroplasty in a prospective randomized
study. Secondary outcomes included: morphine use, patient satisfaction, complication of analgesia and duration
of hospital stay. We analyzed 71 patients with an ASA score of II or III. The patients were randomized into two
groups: group PCA (n=36) was given the PCA pump, which contained morphine; and group FA (n=35) was given first a
bolus dose, then a continuous infusion 0.25% levobupivacain via a femoral catheter. The assessment of VAS was performed
every 2 hours. There were no differences between the PCA and FA groups regarding demographic characteristics,
operation duration, ASA score distribution, duration of hospital stay and satisfaction with analgesia (although there
were more satisfied patients in the FA group). Significant differences were noted in the quantity of morphine used
(higher values were in the PCA group; p<0.001). More complications were recorded in PCA group (p<0.001). The VAS
score was lower in the FA group (p<0.001). The highest difference occurred 4 hours after the operation, with the PCA
group having significantly higher VAS score values compared to the FA group. Femoral analgesia leads to a stronger
pain relief with less side effects, less morphine use and more patient satisfaction than intravenous PCA with morphine.
Ključne riječi
total knee arthroplasty; femoral nerve block; patient controlled analgesia; morphine; levobupivacain
Hrčak ID:
75640
URI
Datum izdavanja:
30.12.2011.
Posjeta: 940 *