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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.24

Abstract

Background: Postoperative pain management in TKR is of imperative importance. Epidural analgesia though considered as a standard technique in postoperative pain management in TKR it was commonly associated with unwanted side effects such as hypotension and urinary retention. FNB is also a common method of analgesia which is a much easier technique to master and has a very low risk of side effects. Aim: To compare the efficacy between continuous epidural analgesia and continuous femoral nerve block for postoperative pain relief in Total knee replacement surgeries. Methodology: The study was conducted by the department of anaesthesiology of Vinayaka Misssions Kirupananda Variyar Medical College and Hospital,salem for a period of 1 year between Jan 2016–Dec 2016. A total of 60 patients were included in our study. 30 patients received continuous femoral nerve block and 30 patients received continuous epidural analgesia. The patient’s pain assessment was done by visual analogue scale and Wong baker faces pain rating scale. Pain assessment was done every 4th hour for 48 hours. Patients were also monitored for any incidence of side effects. Results: Among the patients who had received femoral nerve block the visual analogue pain score ranged between 0 and 2, whereas among the patients who had received epidural analgesia the score ranged between 2 and 4. There was a statistically significant difference in the pain perception between the two groups and a similar type of pain perception was also seen with Wong baker faces pain rating scale. Epidural analgesia group of patients experienced higher incidence of side effects like urinary retention, nausea, vomiting and hypotension compared to femoral nerve block and the difference was found to be statistically significant. Conclusion: Continuous femoral nerve block can be recommended as an effective alternative to epidural analgesia for postoperative pain management in TKR.

Keywords: Epidural Analgesia; Femoral Nerve Block; Pain Rating Scale; Side Effects. 

Corresponding Author : Dr. Senthil M, Assistant Professor, Department of Anesthesiology, Vinayaka Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu 636308, India.