Journal of Orthopaedics Trauma Surgery and Related Research

Journal of Orthopaedics Trauma Surgery and Related Research

An Official Journal of Polish Society of Orthopaedics and Traumatology

ISSN:1897-2276
e-ISSN: 2449-9145

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Ayaz Ali Mir*, Sumairah Ishaq, Rakesh Rajput, Kunal Paul and Sirazul Kamal
 
Department of Orthopaedics, Fortis Super Speciality Hospital, Anandapur, Kolkata, West Bengal, India
 
*Correspondence: Ayaz Ali Mir, Department of Orthopaedics, Fortis Super Speciality Hospital, Anandapur, Kolkata, West Bengal, India, Email: mirayaz25@yahoo.com

Received: 13-Mar-2019 Accepted Date: May 06, 2019 ; Published: 13-May-2019

This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact reprints@pulsus.com

Abstract

Objective: This study compared post-operative analgesic efficacy, morphine consumption, mobilization time and complications of a continuous Femoral Nerve Block (FNB) with Local Infiltration Anesthesia (LIA).s

Material and methods: 60 patients scheduled for unilateral total knee replacement under spinal anesthesia, were randomly allocated in two groups FNB and LIA group. FNB group received bolus dose of drug-containing 20 ml of 0.5% levo bupivacaine plus 50 μg of dexmedetomidine plus 80 μg of fentanyl and in post-operative period an infusion of 0.2% ropivacaine was started of 7 ml per hour while LIA group received a mixture of 100 ml prepared by adding 40 ml 0.5% levo bupivacaine plus 60 mg ketorolac plus 15 mg morphine plus normal saline and given in 2 injections. Postoperative pain severity was measured by using VAS scale, rescue analgesia and mobilization time was also recorded.

Result: LIA group had significantly low VAS pain score at 4, 8, 12 and 24 hours postoperatively as compared to FNB group, the mean morphine consumption in LIA group was significantly less 21.06 ± 10.88, LIA 8.16 ± 10.38, p-value <0.001), also in LIA group more than 95% patients were able to do straight leg raising and were able to move with help at 24 hours postoperatively against only 60% patients in FNB group.

Conclusion: LIA is a newer multimodal analgesic method that gives excellent pain control decreases morphine consumption and preserves quadriceps muscle function thereby improving patient satisfaction which plays a vital role in early ambulation and reducing complications.



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Annals of Medical and Health Sciences Research Journal of Orthopaedics Trauma Surgery and Related Research a publication of Polish Society, is a peer-reviewed online journal with quaterly print on demand compilation of issues published.
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