• Minghe Tan, Bozhou Chen, Qingshu Li, Siqi Wang, Daiyu Chen, Maoji Zhao, and Jun Cao.
• Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
• Clin J Pain. 2024 Mar 20.

ObjectivesThis study aimed to compare the analgesic effects of continuous femoral nerve block (FNB), femoral triangle block (FTB), and adductor canal block (ACB) following total knee arthroplasty (TKA). The goal was to identify the most effective nerve block technique among these three.MethodsPatients undergoing TKA were randomly assigned to one of three groups: FNB, FTB, or ACB. Nerve blocks were administered preoperatively, with catheters placed for patient-controlled nerve analgesia (PCNA). The primary endpoint was the Numeric Rating Scale (NRS) score at movement at 24 hours post-surgery. Secondary endpoints included NRS scores at rest and movement, quadriceps strength, Timed Up and Go (TUG) test performance, range of motion (ROM), effective PCNA utilization, and opioid consumption at various post-surgery time points.ResultsOf the 94 valid datasets analyzed (FNB: 31, FTB: 31, ACB: 32), significant differences were observed in the primary endpoint (H=7.003, P=0.03). Post-hoc analysis with Bonferroni correction showed that the FNB group had a significantly lower median pain score (3 [2-4]) compared to the ACB group (4 [3-5], Bonferroni-adjusted P=0.03). Regarding secondary endpoints, both the FNB and FTB groups had lower NRS scores than the ACB group at various time points after surgery. Quadriceps strength and TUG completion were better in the FTB and ACB groups. There were no statistically significant differences among the groups for the other endpoints.DiscussionContinuous FTB provides postoperative analgesia comparable to FNB, but with the advantage of significantly less impact on quadriceps muscle strength, a benefit not seen with FNB. Both FTB and ACB are effective in preserving quadriceps strength postoperatively.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

14 keywords...

hide…