"Analgesia for Total Knee Arthroplasty: A Randomized Controlled Study Comparing Local Infusion Analgesia, Femoral Nerve Block and Intrathecal Morphine"

Abstract

peripheral nerve blockade, ABSTRACT Introduction: The aim of this study was to compare the effectiveness of continuous intra-articular local infiltration analgesia, femoral nerve block and intrathecal morphine for the management of post-operative pain and early function following total knee arthroplasty. Methods: group, double blinded, randomized controlled pilot trial was undertaken. Patients were randomized to receive either local infiltration analgesia, femoral nerve block or intrathecal morphine for post-operative analgesia following total knee arthroplasty. The efficacy of analgesia was determined by recording post-operative pain visual analogue scores, opiate requirements and side effects, and functional scores at 24 hours, 48 hours, and 6 weeks post-operatively. Results: 45 patients were recruited to the study. 4 were excluded due to voluntary withdrawal and incomplete follow-up. The final analysis included 13 patients randomized to the local infiltration analgesia group, 14 patients to the femoral nerve block group and 14 patients to the intrathecal morphine group. There were no significant differences in post-operative pain scores, opiate requirements and associated side effects, or functional scores at any point during the study period. Conclusion: This study did not identify any significant differences between continuous intra-articular local infiltration analgesia, femoral nerve block and intrathecal morphine for delivering post-operative an-algesia following total knee arthroplasty.