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Pain management following simultaneous bilateral total knee arthroplasty: genicular nerve blockade versus periarticular injection

医学 可视模拟标度 外科 止痛药 全膝关节置换术 运动范围 关节置换术 麻醉 膝关节 股神经 回顾性队列研究
作者
Abdullah Küçükalp,Bülent ÖZDEMİR
出处
期刊:Acta Orthopaedica Belgica [Acta Orthopaedica Belgica]
卷期号:89 (2): 307-315
标识
DOI:10.52628/89.2.11542
摘要

The aim of the present study was to investigate whether the analgesic solution prepared for periarticular injection (PAI) could be utilized as a genicular nerve blockade (GNB) agent in bilateral knee arthroplasty, and to assess the pain control efficacy of this approach in comparison with PAI. This was a retrospective cohort in which patients undergoing simultaneous bilateral total knee arthroplasty (TKA) were evaluated. Thirty patients were enrolled. The standard PAI was used for one knee, while the PAI solution was applied in the form of GNB to the other. Visual Analog Scale (VAS) pain scores were measured and recorded separately for each knee, at rest (static) and during exercise (dynamic). Active range of joint motion (JRM) for both knee joints was measured preoperatively, at postoperatively. Compared to the PAI group, the GNB group had lower VAS scores at 2 and 8 hours (p = 0.030 and p < 0.001, respectively). The GNB group also had lower dynamic VAS scores at 2, 8, and 24 hours (p = 0.009, p <0.001 and p<0.001, respectively). Static and dynamic VAS measurements did not demonstrate any differences between groups (GNB vs. PAI) at 48 hours and 30 days (p>0.05). When the reduction in VAS scores was assessed, we found that the decrease in both scores was significantly greater in the PAI group compared to the GNB group (p<0.001, for both). There were no significant differences between the groups with regard to drainage volume, complications and JRM (p>0.05). GNB was found to be more effective for pain control throughout the first postoperative day in patients who underwent simultaneous bilateral TKA.
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