Femoral nerve block versus local infiltration analgesia for postoperative pain after total knee arthroplasty

Abstract

Objective This prospective study compares the pain control after total knee replacement using a single-shot femoral nerve block (FNB) against local infiltration analgesia (LIA). Patients and methods Sixty-four patients were included the study. A total of 29 patients received single-shot ultrasound-guided FNB at the end of the procedure, whereas 35 patients received LIA. Both groups were compared as regards pain at 2 and 4 h after surgery, pain before and after physical therapy on the first postoperative day, early flexion of the knee to 90°, total opiate use, and length of stay in the hospital. Results All patients completed the study. The group that received LIA showed significantly less pain at 4 h postoperatively, on the first postoperative day, and after physical therapy. The LIA group also showed significantly better rehabilitation and less hospital stay. Patients who received FNB used significantly more opiate compared with the LIA group. Conclusion LIA gives better pain control compared with single-shot FNB after total knee replacement.