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Category: Volume 07 Issue 11 November 2019
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Title: USG Guided Femoral Nerve Block versus Local Infiltration Analgesia for Post Operative Pain Relief in Knee Arthroscopy Surgeries

Authors: Dr Aroma Raghav, MBBS, Dr Charu Bamba, MD, MBBS

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.20

Abstract

Background: A good analgesic technique which is safe and easy to administer is an essential requirement in knee arthroscopy surgeries for early rehabilitation and faster recovery.

Objectives: 1) Postoperative pain assessment by the Numeric Pain Rating Scale at 0/4/8/12 hrs. 2) Total analgesic requirement & time to first rescue in both groups.

Methods: 110 patients were randomised to receive either USG guided FNB (n= 55) with 20ml of 0.375% ropivacaine or LIA (n=55) with a total solution of 20ml (15 ml of 0.375% ropivacaine with 30 mg ketorolac and 0.3mg epinephrine making a total volume of 20ml) with 15ml infiltrated intra articularly and 5 ml at the incision site along with the portal sites. Demographic data, NRS at 0,4,8 and 12 hrs, time to rescue analgesia, total analgesic requirement and quadriceps strength were recorded.

Results: Significant difference in pain scores at 12 hrs was observed (p = 0.01). An extremely significant difference was observed in the total analgesic requirement (p = 0.0004) with only 30 patients in LIA group requiring analgesia as compared to 47 in FNB group. Demographically the patients in both groups were similar. The quadriceps muscle strength was similar in both the groups.

Interpretation & Conclusion: The technique of LIA provides longer duration of analgesia with reduced supplementary analgesic requirement during the post-operative period.

Keywords: Analgesia, Femoral Nerve Block, Knee arthroscopy, Local Infiltration Analgesia, Pain, USG.

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Corresponding Author

Dr Charu Bamba, MD, MBBS

Consultant & Associate Professor, Department of Anaesthesiology and Intensive Care

Main OT building, Ground floor, VMMC & Safdarjung Hospital, New Delhi