Which regional anesthesia technique is best for managing pain after knee replacements? 5 insights

A study, published in the Journal of Orthopaedic Surgery and Research, examined different pain management techniques for patients undergoing total knee arthroplasty, Clinical Pain Advisory reports.

The study claims sciatic nerve block used in combination with femoral nerve block is more effective with fewer adverse events than local infiltration analgesia and femoral nerve block.

Here's what you should know:

1. Femoral nerve block was traditionally used for regional anesthesia in TKA patients. However researchers said it did not sufficiently control pain. The optimal method for managing pain was unclear.

2. In this study researchers examined 273 patients from four randomized controlled trials and two non-randomized controlled trials. The studies each assessed pain at 12, 24 and 48 hours.

3. At 12 and 24 hours, sciatic nerve block when used in combination with femoral nerve block was more effective at managing pain than local infiltration analgesia and femoral nerve block on a visual analog scale.

4. There were no differences in visual analog scale scores at 48 hours.

5. Patients on SNB with FNB consumed less morphine at 24 hours but not at 48 hours, where rates between the two groups were similar.

Researchers concluded, "FNB-combined SNB provides superior pain relief and less morphine consumption within the first 24 h compared with FNB-combined LIA in total knee arthroplasty. In addition, there were fewer side effects associated with SNB."

They said a multicenter randomized controlled trial is needed to validate the results.

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