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POSTOPERATIVE ATTAIMNENT TIME FOR DISCHARGE CRITERIA AND ACQUISITION OF 'SEIZA' SITTING AFTER KNEE ARTHROPLASTY - COMPARISON OF FEMORAL TRIANGLE BLOCK WITH FEMORAL NERVE BLOCK
Author(s): ,
Sakai, N.*
Affiliations:
Daiyukai General Hospital, Dep. Anaesthesiology, Ichinomiya, Japan
Takada, M.
Affiliations:
Daiyukai General Hospital, Dep. Anaesthesiology, Ichinomiya, Japan
ESRA Academy. Sakai N. Sep 13, 2017; 190851
Topic: Lower Limb Blocks - Femoral Nerve Block (including Fascia Iliaca and Saphenous Nerve Block)
Disclosure(s): There is no need to disclose actual financial value
Dr. Norihiro Sakai
Dr. Norihiro Sakai

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Abstract
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Background and Aims:

Femoral nerve block (FNB) is a gold standard for postoperative pain management after total knee arthroplasty (TKA) however it leads quadriceps. Femoral triangle block (FTB) on the apex of femoral triangle is a excellent counter plan for answering the unclear problem of adductor canal block (ACB) which has a confusing definition of block administration point without quadriceps weakness. We compared the effect of FTB for postoperative rehabilitation progression with FNB.

Methods:

This was a retrospective chart review and our Institutional Review Board approved. Seventy-two subjects received single FNB or FTB with 0.25% ropivacaine 12mL before receiving TKA. We also administered preoperative tibial nerve block with 0.25% ropivacaine. We evaluated early discharge criteria (good pain control with oral analgesics without opiate, ability of knee flexion above 90 degrees, and gait rehabilitation without a help of physical therapist or nursing staff), ability of straight leg raise test (SLR) and availability of deep knee flexion including Japanese stile "Seiza" sitting.  

Results:

Postoperative attainment time for discharge criteria was not significantly different between two treatment groups,as FTB was 68.0 hours (range: 38-98 hours) versus FNB was 68.5 hours (41-116 hours). FTB group could acquire SLR test on POD1 (FTB; 32 patients versus FNB; 12 patients; p<0.001). Other outcomes was not significantly different. Patients who could attain "Seiza" sitting were also not different on the postoperative 3 months (FNB;12 patients, FTB;12 patients). 

Conclusions:

Postoperative attainment time for discharge and other rehabilitation milestone after TKA was not statistically different among two techniques, however FTB produced earlier postoperative SLR.

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