Comparison of Rebound Pain and Postoperative Tramadol Requirement in Patients Who Had Femoral Nerve Block or Adductor Canal Block for Pain after Total Knee Arthroplasty Total Diz Artroplastisi Sonrasi Agri Kontrolü Icin Femoral Sinir Blogu ya da Adduktor Kanal Blogu Yapilmis Hastalarda Rebound Agri ve Postoperatif Tramadol Gereksiniminin Karsilastirilmasi
Anestezi Dergisi, cilt.29, sa.4, ss.254-262, 2021 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 4
- Basım Tarihi: 2021
- Doi Numarası: 10.5222/jarss.2021.60590
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.254-262
- Anahtar Kelimeler: Adductor canal block, Femoral nerve block, Rebound pain, Total knee arthroplasty
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: It was aimed to compare the rebound pain and postoperative tramadol requirement in patients who underwent femoral nerve or adductor canal block after total knee replacement surgery under general anesthesia. Methods: Fifty ASA I-III patients, 18-80 years of age, who underwent total knee replacement surgery and underwent these blocks after induction of anesthesia for postoperative analgesia, were examined in the postoperative period. The patients were divided into 2 groups as FNB (femoral nerve block) and ACB (adductor canal block) (Group F and Group AC). Patient controlled analgesia (PCA) was applied to all patients with intravenous tramadol as a rescue analgesic. 75 mg diclofenac sodium was administered intramuscularly for additional analgesic requirement. Postoperative pain scores, tramadol consumption, additional analgesic requirement, incidence of rebound pain and other complications were recorded. Visual Analogue Scale (VAS) and Bromage scales were used to monitor pain and motor weakness in the postoperative period. The data were analyzed with the SPSS 20.0 statistical program. Results: Three of the 7 patients with rebound pain were in the femoral block group, while the other 4 patients were in the adductor canal block group. Rebound pain durations were followed as 50, 60, 120 and 60, 60, 90, 110 minutes, in group F and group AK, respectively. The frequency and duration of rebound pain were similar. It was found that postoperative pain scores at 0. 2. 4. and 8. hours were statistically significantly lower in patients who underwent femoral block than those who received adductor canal block. Bromage scores at 0, 2 and 4 hours in the femoral block group were statistically lower than the adductor canal block group. Tramadol consumption with PCA was significantly lower in the femoral block group than in the adductor block group. When total tramadol consumption and additional analgesic requirement were compared with postoperative complications, no statistically significant difference was found between the two groups. Patient satisfaction scores in both groups were similar. Conclusion: The frequency and duration of rebound pain in both groups were similar. We found that femoral block provides more effective analgesia in the first 8 hours compared to adductor canal block. Request to use PCA was significantly lower in the femoral block group. There was no statistically significant difference between postoperative complications and additional analgesic needs.