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AIM To compare the efficacy of intrathecal morphine and single shot femoral nerve block for patients undergoing primary total knee arthroplasty.METHODS Data was extracted from electronic medical records and case-paper record files of patients who underwent unilateral primary total knee arthroplasty under spinal anesthesia using bupivacaine 12.5 mg with intrathecal morphine(ITM)0.2 mg and under general anesthesia(GA)with single shot femoral nerve block(FNB)using 20 mL 0.5%bupivacaine at our hospital in 2013 and 2014.All patients had received peri-articular infiltration as per the hospital protocol.Data for gender,age,weight,American Society of Anesthesiologists status,total surgical time,postoperative pain score using visual analogue scale(VAS)from 1 to 10 at 6 h,12 h and 24 h postoperatively,24 h opioid consumption,use of oral multimodal analgesia,postoperative high dependency unit(HDU)admission and the time to discharge from the hospital was collected.The data was analyzed using Mann-Whitney U test for continuous variables and Fischer’s exact-t-test for categorical variables.RESULTS Twenty-two patients in ITM group and 32 patients in FNB group were analyzed.Median pain scores using VAS in ITM group were significantly lower at 6 h(0.0 vs 2.0,P<0.001),12 h(0.0 vs 2.0,P<0.001)and 24 h(0.0 vs 2.0,P<0.001)postoperatively.Also,postoperative morphine consumption in ITM group was significantly lower(P<0.001).However,median of nonsteroid anti-inflammatory drug unit requirement in 24 h postoperatively was statistically significant higher in ITM compared to FNB group(2.0 vs 1.0,P=0.025).The difference in postoperative paracetamol consumption in 24 h was not statistically significant(P=0.147).There was no significant difference in the postoperative HDU admission or time to discharge from the hospital.No respiratory depression in either group was noticed.CONCLUSION The ITM group patients had much lower pain scores and morphine requirement in the first 24 hour postoperatively compared to FNB group.
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篇名 Intrathecal morphine vs femoral nerve block for postoperative-analgesia after total knee arthroplasty:A two-year retrospective analysis
来源期刊 世界麻醉学杂志 学科 医学
关键词 POSTOPERATIVE ANALGESIA Intrathecal morphine Femoral nerve block TOTAL KNEE ARTHROPLASTY Pain AFTER TOTAL KNEE ARTHROPLASTY
年,卷(期) 2016,(3) 所属期刊栏目
研究方向 页码范围 67-72
页数 6页 分类号 R
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POSTOPERATIVE
ANALGESIA
Intrathecal
morphine
Femoral
nerve
block
TOTAL
KNEE
ARTHROPLASTY
Pain
AFTER
TOTAL
KNEE
ARTHROPLASTY
研究起点
研究来源
研究分支
研究去脉
引文网络交叉学科
相关学者/机构
期刊影响力
世界麻醉学杂志
不定期
2218-6182
北京市朝阳区东四环中路62号楼远洋国际中
出版文献量(篇)
68
总下载数(次)
0
总被引数(次)
0
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