TO STUDY THE EFFICACY OF FEMORAL NERVE BLOCK WHEN USED AS A PART OF MULTIMODAL ANALGESIA REGIMEN IN PATIENTS UNDERGOING KNEE ARTHROPLASTY PERFORMED UNDER SUBARACHNOID BLOCK

Abstract

Total Knee Arthroplasty (TKA) is a common orthopaedic procedure, consisting of replacing diseased or damaged knee joint surfaces to relieve the pain and disability of osteoarthritis AimTostudy and compare the efficacy of femoral nerve block and adductor canal block when used as a part of multimodal analgesia regimen in patients undergoing Total Knee Arthroplasty under subarachnoid bloc. The ASA 100 strongly recommends that regional blockade with local anaesthetics be considered as a part of the multimodal approach for pain management. Regional block such as femoral nerve block, with local anaesthetics remains a well- accepted component of comprehensive multimodal anaesthesia for postoperative pain management Aim: Tostudy and compare the efficacy of femoral nerve block and adductor canal block when used as a part of multimodal analgesia regimen in patients undergoing Total Knee Arthroplasty under subarachnoid block.Objectives: To assess the effect of femoral nerve block and adductor canal block on the Pain intensity by NRS scale at specific time intervals, till 24hours post block, the duration of sensory blockade, the duration of motor blockadeandto measure the total amount of opioids consumed, till 24 hours post block. Study population: Studypopulation was limited to the patients undergoing elective TKA under SAB under same surgeon. Sample size & sample technique: Sample size was limited to 150 patients systematically divided into two equal groups of 75 patients in each group We found that the mean NRS pain score at 6 hours, 12 hours and 24 hours in both the groups were similar with the difference being statistically insignificant. In group A mean NRS pain score at 6 hours was 2.8400 ± 1.4708 and in groupB it was 2.6933 ± 1.5594 with p value of 0.5544. Mean NRS pain score at 12 hours in group A was 4.9467 ± 1.3939 and in group B it was 4.9067 ± 1.2858 with p value of0.8553.Mean NRS pain score at 24 hours in group A was 3.0533 ± 1.4036 and in group B it was 2.9733 ± 1.3252 with the p value of 0.7202.We found that the difference in duration of sensory block was also not statistically significant in both the groups with mean duration of sensory block inhoursbeing9.2400 ±1.8733ingroup Aand 8.8133 ±1.9844in groupB with p value of -0.1778 and total amount of opioid consumption was also similar in boththegroupswithmeanopioidconsumptioninmicrogramsbeing132.6000± 31.9666 in group A and 134.3333 ± 30.4841 in group B with p value of 0.7345 100.