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 - 04/05/22
, Isabelle Besançon a, Antoine Hivert a, Anne Marine Plouhinec a, Mathieu Oudot a, Guillaume Venet b, Nicolas Fraquet b, Julien Cousin b, Lucie Planche c, Catherine Ganière d, Alexis Duchalais aAbstract |
Background |
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.
Methods |
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.
Results |
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 < 0.001). During the first four POD assessments, quadriceps strength evaluated with a dynamometer was less diminished in the FTB-Cath group (p < 0,001). There was no difference between groups regarding pain scores, TUG test results and 30MWT assessment.
Conclusion |
The FTB-Cath provided a better preservation of quadriceps strength than the F-Cath in TKA, with a similar pain relief.
Le texte complet de cet article est disponible en PDF.Keywords : Total knee arthroplasty, Rehabilitation, Regional analgesia, Femoral block, Femoral triangle block, Ropivacaine
Plan
Vol 41 - N° 2
Article 101043- avril 2022 Retour au numéro
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