Outpatient Unicompartment Knee Arthroplasty With Indwelling Femoral Nerve Catheter

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• 作者：Geoffrey F. Dervin ; MD ; MSc ; FRCSC^鈦?/sup> ; ; Susan M. Madden ; BScN ; MEd^&dagger ; ; Barbara A. Crawford-Newton ; RN ; BScN ; MAL.^&Dagger ; ; Alan T. Lane ; MB ; FCARCSI^&sect ; ; Holly C. Evans ; MD ; FRCPC^&sect ;
• 关键词：unicompartment knee arthroplasty (UKA) ; femoral nerve block ; outpatient ; multimodal pain management ; postoperative pain
• 刊名：The Journal of Arthroplasty
• 出版年：2012
• 期刊代码：326_08835403
• 类别：med
• 出版时间：June, 2012
• 卷：27
• 期：6
• 页码：1159-1165.e1
• 文件大小：130 K

摘要

Contemporary multimodal anesthesia regimens allow the performance of unicompartment knee arthroplasty (UKA) on an outpatient basis. Our initial pilot experience is presented using a continuous femoral nerve block as an adjunct for 24 patients classified as American Society of Anesthesiology class 1 (14 men, 10 women; median age, 56 years; range, 46-72 years). After minimally invasive UKA, patients documented their pain and oral medication use while at home for the first 5 days. Adverse events, medication adverse effects, and the amount of infused ropivacaine were recorded. Median pain scores for the first 3 days were 1, 2, and 2 (at rest) and 4, 5, and 3 (during physical therapy). Eighteen patients (75%) required less than 4 mg oral hydromorphone/d. Of the 18, 10 (42%) did not require supplemental oral opioids. The median catheter use was 3 days. Our results suggest that with careful patient selection and adequate teaching, continuous femoral nerve blocks may be used as part of a multimodal pain regimen to assist the delivery of outpatient UKA with high patient satisfaction.