Femoral nerve inguinal approach versus proximal femoral triangle ap proach for continuous regional analgesia in active rehabilitation after total knee arthroplasty: A prospective, randomised study

A catheter in femoral nerve block (F-Cath) is an effective regional analgesia technique in total knee arthroplasty (TKA) but results in significant quadriceps weakness. The femoral triangle catheter (FTB-Cath) seems to be an interesting alternative. In this study, we aim to demonstrate that the nerv...

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Published in:Anaesthesia critical care & pain medicine 2022-04, Vol.41 (2), p.101043-101043, Article 101043
Main Authors: Guilley, Jérôme, Besançon, Isabelle, Hivert, Antoine, Plouhinec, Anne Marine, Oudot, Mathieu, Venet, Guillaume, Fraquet, Nicolas, Cousin, Julien, Planche, Lucie, Ganière, Catherine, Duchalais, Alexis
Format: Article
Language:English
Subjects:
Analgesia - methods
Analgesics, Opioid
Anesthetics, Local
Arthroplasty, Replacement, Knee - methods
Femoral block
Femoral Nerve
Femoral triangle block
Humans
Pain, Postoperative - drug therapy
Prospective Studies
Regional analgesia
Rehabilitation
Ropivacaine
Total knee arthroplasty
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Summary:A catheter in femoral nerve block (F-Cath) is an effective regional analgesia technique in total knee arthroplasty (TKA) but results in significant quadriceps weakness. The femoral triangle catheter (FTB-Cath) seems to be an interesting alternative. In this study, we aim to demonstrate that the nerve block administration for analgesic purposes via an FTB-Cath results in less quadriceps weakness than via an F-Cath. This study included patients scheduled for TKA performed under general anaesthesia. The patients were randomised to receive either an F-Cath or an FTB-Cath. A unique regimen of 0.2% ropivacaine was administrated for 72 h. The primary endpoint was quadriceps strength assessed clinically on postoperative day (POD) 2 by the Manual Muscle Test (MMT) using a motor grading scores (0–5). The secondary endpoints were quadriceps strength measured by a dynamometer, the Timed Up and Go (TUG) test, the 30-m walk test (30MWT) and pain scores. Forty-four patients were analysed (22 in each group). On POD 2, 77.3% of the patients in the FTB-Cath group had MMT scores ≥ 4 and 13.6% in the F-Cath group (p 
ISSN:2352-5568
2352-5568
DOI:10.1016/j.accpm.2022.101043