Comparison of Analgesia Produced by preoperative Ultrasound-guided Femoral Nerve Blocks and Postoperative Intravenous Administration of Opioids in Patients Undergoing Hip Replacement Surgery
-
Moloud Zolfaqari
,
Mehrdad Mokaram Dori
,
Seyed Hossein Khademi
,
Mehryar Taghavi Gilani
,
Maliheh Ziaee
,
Tayyebe Ghanei
Abstract
Background: Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery.
Methods: This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia.
Results: After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group.
Conclusion: The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.
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[11] Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d'Athis F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999; 91(1):8-15.
[12] Chelly JE, Greger J, Gebhard R, Coupe K, Clyburn TA, Buckle R, Criswell A. Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty. J Arthroplasty. 2001; 16(4):436-45.
[13] Prabhakar H, Rath S, Kalaivani M, Bhanderi N. Adrenaline with lidocaine for digital nerve blocks. Cochrane Database Syst Rev. 2015; 2015(3):CD010645.
[14] Abrahams M, Aziz M, Fu R, Horn J-L. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2009; 102(3):408.
[15] Marhofer P, Chan VW. Ultrasound-guided regional anesthesia: current concepts and future trends. Anesth Analg. 2007; 104: 1265-9.
[16] Aziz MF, Abrahams MS, Horn JL. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block. Br J Anaesth. 2009; 102(3):408-17.
[17] Munirama G, McLeod A. systematic review and meta-analysis of ultrasound versus electrical stimulation for peripheral nerve location and blockade. Anesthesia. 2015; 10(6):1111.
[18] Fiorentin JZ, Martins AV, Cañola JM, Gutierrez LC, Perches F, Sakae TM, et al. Comparison between subarachnoid morphine and femoral nerve block for analgesia after knee ligament reconstruction: a randomized clinical trial. Revista Brasileira de Anestesiologia. 2021; 70:613-9.
[19] Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004; 29(2):102-9.
[20] Wang X, Sun Y, Wang L, Hao X. Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty; A meta-analysis from randomized controlled trials. Medicine (Baltimore). 2017; 96(27): e7382.
[21] Michael A. Gropper, Ronald D Miller, Miller’s Anesthesia, 9th edition, 2020 Elsevier,ch:81 P2617, ch 24:P 701-2, 704
[22] Mokaram-dori M, Rezaei H, Abadi MK. Femoral nerve block by nerve stimulator with or without ultrasonography guide for postoperative pain management of isolated femoral shaft fracture. Anesthesiology and Pain. 2016; 6(4):26-32.
[23] Kuchalik J, Magnuson A, Lundin A, Gupta G. Local infiltration analgesia or femoral nerve block for postoperative pain management in a patient undergoing total hip arthroplasty. A randomized, double-blind study. Scand J Pain. 2017; 16:223-230.
[24] Vandebroek A, Vertommen M, Huyghe M. Ultrasound-guided femoral nerve block and lateral femoral cutaneous nerve block for postoperative pain control after primary hip arthroplasty. Acta Anaesthesiol Belg. 2014; 65(1):39-44.
[25] Sites BD, Beach ML, Chinn CD, Redborg KE, Gallagher JD. A comparison of sensory and motor loss after a femoral nerve block was conducted with ultrasound versus ultrasound and nerve stimulation. Reg Anesth Pain Med. 2009; 34(5):508-13.
[26] Nielsen KC, Klein SM, Steele SM. Femoral Nerve Blocks. Tech Reg Anesth Pain Manage. 2003; 7(1):8-17.
[27] Allen HW, Liu SS, Ware PD, Nairn CS, Owens BD. Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesth Analg. 1998; 87(1):93-7.
[28] Szczukowski MJ Jr, Hines JA, Snell JA, Sisca TS. Femoral nerve block for total knee arthroplasty patients: a method to control postoperative pain. J Arthroplasty. 2004; 19(6):720-5.
[29] Kadic L, Boonstra MC, Malefijt DW, Lako SJ, Egmond J, Driessen JJ. Continuous femoral nerve block after total knee arthroplasty? Acta Anaesthesiol Scand. 2009; 53(7):914-20.
[30] Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010; 28(1):76-81.
[31] Li J, Dai F, Ayala KE, Zhou B, Schonberger RB, Sharma A. Transmuscular Quadratus Lumborum and Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty. Clin J Pain. 2021; 37(5):366-371.
[32] Wu Y, Hu J, Xu M, Yang J. A Commentary on "Transmuscular Quadratus Lumborum and Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty. Clin J Pain. 2021; 37(10):788.
[33] Rahimzadeh P, Imani F, Feiz H, Khaladbarin A, Abbasi A. Interventional study of ultrasound-guided femoral nerve block in adductor canal and comparison with the classical method in relieving pain after elective knee surgery. Anesthesiology and Pain. 2015; 6(3):1-8.
[2] Keisu KS, Orozco F, Sharkey PF, Hozack WJ, Rothman RH, McGuigan FX. Primary cementless total hip arthroplasty in oc togenarians. Two to eleven-year follow-up. J Bone Joint Surg Am. 2001; 83-A(3):359-63
[3] Lachiewicz PF, Messick P. Precoated femoral component in primary hybrid total hip arthroplasty: results at a mean 10-year follow-up. J Arthroplasty. 2003; 18(1):1-5.
[4] Meding JB, Ritter MA, Keating EM, Faris PM, Edmondson K. A comparison of collared and collarless femoral components in primary cemented total hip arthroplasty: a randomized clinical trial. J Arthroplasty. 1999; 14(2):123-30
[5] Uo MH, Gilbert NF, Parvizi J. What's new in total hip arthroplasty? J Bone Joint Surg Am. 2007; 89(8):1874-85.
[6] Siopack JS, Jergesen HE. Total hip arthroplasty. West J Med. 1995; 162(3):243-9.
[7] Zhan C, Kaczmarek R, Loyo-Berrios N, Sangl J, Bright RA. Incidence and short-term outcomes of primary and revision hip replacement in the United States. J Bone Joint Surg Am. 2007; 89(3):526-33.
[8] Harris WH, Maloney WJ. Hybrid total hip arthroplasty. Clin or Orthop Relat Res. 1989; (249):21-9.
[9] Robert W. Acute Postoperative Pain.in: Miller R.D. Miller's Anesthesia. 7th ed. California; Elsevier. 2010:2757-71, 1652-3, 2757-2760.
[10] Sites BD, Beach M, Gallagher JD, Jarrett RA, Sparks MB, Lundberg CJ. A single injection ultrasound–assisted femoral nerve block provides side effect-sparing analgesia when compared with intrathecal morphine in patients undergoing total knee arthroplasty. Anesth Analg. 2004; 99(5): 1539-43.
[11] Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d'Athis F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999; 91(1):8-15.
[12] Chelly JE, Greger J, Gebhard R, Coupe K, Clyburn TA, Buckle R, Criswell A. Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty. J Arthroplasty. 2001; 16(4):436-45.
[13] Prabhakar H, Rath S, Kalaivani M, Bhanderi N. Adrenaline with lidocaine for digital nerve blocks. Cochrane Database Syst Rev. 2015; 2015(3):CD010645.
[14] Abrahams M, Aziz M, Fu R, Horn J-L. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2009; 102(3):408.
[15] Marhofer P, Chan VW. Ultrasound-guided regional anesthesia: current concepts and future trends. Anesth Analg. 2007; 104: 1265-9.
[16] Aziz MF, Abrahams MS, Horn JL. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block. Br J Anaesth. 2009; 102(3):408-17.
[17] Munirama G, McLeod A. systematic review and meta-analysis of ultrasound versus electrical stimulation for peripheral nerve location and blockade. Anesthesia. 2015; 10(6):1111.
[18] Fiorentin JZ, Martins AV, Cañola JM, Gutierrez LC, Perches F, Sakae TM, et al. Comparison between subarachnoid morphine and femoral nerve block for analgesia after knee ligament reconstruction: a randomized clinical trial. Revista Brasileira de Anestesiologia. 2021; 70:613-9.
[19] Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med. 2004; 29(2):102-9.
[20] Wang X, Sun Y, Wang L, Hao X. Femoral nerve block versus fascia iliaca block for pain control in total knee and hip arthroplasty; A meta-analysis from randomized controlled trials. Medicine (Baltimore). 2017; 96(27): e7382.
[21] Michael A. Gropper, Ronald D Miller, Miller’s Anesthesia, 9th edition, 2020 Elsevier,ch:81 P2617, ch 24:P 701-2, 704
[22] Mokaram-dori M, Rezaei H, Abadi MK. Femoral nerve block by nerve stimulator with or without ultrasonography guide for postoperative pain management of isolated femoral shaft fracture. Anesthesiology and Pain. 2016; 6(4):26-32.
[23] Kuchalik J, Magnuson A, Lundin A, Gupta G. Local infiltration analgesia or femoral nerve block for postoperative pain management in a patient undergoing total hip arthroplasty. A randomized, double-blind study. Scand J Pain. 2017; 16:223-230.
[24] Vandebroek A, Vertommen M, Huyghe M. Ultrasound-guided femoral nerve block and lateral femoral cutaneous nerve block for postoperative pain control after primary hip arthroplasty. Acta Anaesthesiol Belg. 2014; 65(1):39-44.
[25] Sites BD, Beach ML, Chinn CD, Redborg KE, Gallagher JD. A comparison of sensory and motor loss after a femoral nerve block was conducted with ultrasound versus ultrasound and nerve stimulation. Reg Anesth Pain Med. 2009; 34(5):508-13.
[26] Nielsen KC, Klein SM, Steele SM. Femoral Nerve Blocks. Tech Reg Anesth Pain Manage. 2003; 7(1):8-17.
[27] Allen HW, Liu SS, Ware PD, Nairn CS, Owens BD. Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesth Analg. 1998; 87(1):93-7.
[28] Szczukowski MJ Jr, Hines JA, Snell JA, Sisca TS. Femoral nerve block for total knee arthroplasty patients: a method to control postoperative pain. J Arthroplasty. 2004; 19(6):720-5.
[29] Kadic L, Boonstra MC, Malefijt DW, Lako SJ, Egmond J, Driessen JJ. Continuous femoral nerve block after total knee arthroplasty? Acta Anaesthesiol Scand. 2009; 53(7):914-20.
[30] Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010; 28(1):76-81.
[31] Li J, Dai F, Ayala KE, Zhou B, Schonberger RB, Sharma A. Transmuscular Quadratus Lumborum and Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty. Clin J Pain. 2021; 37(5):366-371.
[32] Wu Y, Hu J, Xu M, Yang J. A Commentary on "Transmuscular Quadratus Lumborum and Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty. Clin J Pain. 2021; 37(10):788.
[33] Rahimzadeh P, Imani F, Feiz H, Khaladbarin A, Abbasi A. Interventional study of ultrasound-guided femoral nerve block in adductor canal and comparison with the classical method in relieving pain after elective knee surgery. Anesthesiology and Pain. 2015; 6(3):1-8.
| Files | ||
| Issue | Vol 10 No 3 (2024): Summer |
|
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/aacc.v10i3.15692 | |
| Keywords | ||
| Hip joint Analgesia Nerve block Opioid femur morphine ultrasound pain | ||
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How to Cite
1.
Zolfaqari M, Mokaram Dori M, Khademi SH, Taghavi Gilani M, Ziaee M, Ghanei T. Comparison of Analgesia Produced by preoperative Ultrasound-guided Femoral Nerve Blocks and Postoperative Intravenous Administration of Opioids in Patients Undergoing Hip Replacement Surgery. Arch Anesth & Crit Care. 2023;10(3):239-246.
