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Indian Journal of Anesthesia and Analgesia

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Comparison between Ultrasound Guided Continuous Femoral Nerve Block with Continuous Epidural Analgesia for Post Operative Pain Relief in Major Knee Surgeries

Dr. R. Ganesapandian, Resident, Institute of Anaesthesiology, Madurai Medical College, Madurai– 625020, Tamil Nadu, India. , D.S. Sudhakar1 , R. Ganesapandian2 , Ramohan2

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Indian Journal of Anesthesia and Analgesia 4(3):p 794-800, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.40

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Abstract

Introduction: Regional analgesia is widely used for total knee replacement surgeries (TKR) as it has lesser side-effects and better analgesic efficacy when compared with traditional oral analgesics. Peripheral nerve blockade has also been utilized, including continuous infusion techniques. With the use of ultrasound, the needle and catheter placement can be done accurately under real-time guidance. Materials and Methods: It is a randomized controlled study. The study was approved by institutional ethical committee and consent was obtained from the patients. 60 consecutive patients who are posted for the major knee surgeries selected according to inclusion and exclusion criteria and randomized in to two groups. Group I CEA (continuous epidural analgesia) had an epidural catheter using 16 or 18 G epidural needle inserted at L2-L3 interspace whereas in Group II CFB (continuous femoral block), femoral catheters was done using ultrasound guidance. VAS scores (0-10) for pain, the use of rescue analgesic and side effects like hypotension, vomiting, itching and urinary retention were recorded. Results: There is no significant difference in the age distribution between the two groups. In this study we did not notice any significant difference in the pain level after 6hrs of the post op period between the two groups as evident in the VAS scores. There was a significant fall in the BP in Group I compared to Group II during most of the hours of monitoring. Incidence of vomiting, bradycardia and urinary retention are more in Group I whereas patient acceptance is more with Group II. Conclusion: Within the limitations of this study, we conclude that CFB using ultrasound guidance provides equivalent analgesia with decreased exposure to potentially significant neurological complications.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.40

Keywords

Continuous Femoral Block; Continuous Epidural Analgesia; TKR; VAS Score.

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