Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study

Purpose. To compare preemptive multimodal analgesia (PMMA) without femoral nerve blocks (FNB) to PMMA including FNB following total knee arthroplasty (TKA). Methods. In a prospective, controlled pilot study, subjects with noninflammatory arthritis undergoing TKA and a short postoperative stay receiv...

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Main Authors: Lauren A. Beaupre, D. Bill C. Johnston, Sherry Dieleman, Ban Tsui
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/2012/273821
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author Lauren A. Beaupre
D. Bill C. Johnston
Sherry Dieleman
Ban Tsui
author_facet Lauren A. Beaupre
D. Bill C. Johnston
Sherry Dieleman
Ban Tsui
author_sort Lauren A. Beaupre
collection DOAJ
description Purpose. To compare preemptive multimodal analgesia (PMMA) without femoral nerve blocks (FNB) to PMMA including FNB following total knee arthroplasty (TKA). Methods. In a prospective, controlled pilot study, subjects with noninflammatory arthritis undergoing TKA and a short postoperative stay received either PMMA + FNB (FNB group; n=19) or PMMA only (PMMA group; n=20). No preoperative group differences were noted. Evaluations occurred in hospital and at 2, 6, and 12 weeks postoperatively. The primary outcome (knee flexion) was measured on day two postoperatively. Rehabilitation indices, pain, analgesic use, and length of stay (LOS) were also measured. Results. All subjects completed the study. The only significant group differences were quadriceps motor blocks in the FNB group (P<0.001). No significant differences were noted in ROM, pain levels, analgesic use, or hospital LOS. Conclusion. Other than the quadriceps motor block, no group differences were noted; both achieved satisfactory analgesia. Best postoperative pain management strategies when following a short hospital stay program are still unclear.
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spelling doaj-art-a9300cc774e64f059b9be7446a7ba80d2025-08-20T03:39:36ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/273821273821Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot StudyLauren A. Beaupre0D. Bill C. Johnston1Sherry Dieleman2Ban Tsui3Department of Physical Therapy, University of Alberta, Edmonton, AB, T6G 2G4, CanadaDivision of Orthopaedic Surgery, Department of Surgery, University of Alberta, 1F1.52 WMC, 8440-112 Street, Edmonton, AB, T6G 2B7, CanadaDivision of Orthopaedic Surgery, Department of Surgery, University of Alberta, 1F1.52 WMC, 8440-112 Street, Edmonton, AB, T6G 2B7, CanadaDepartment of Anesthesiology and Pain Medicine, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, T6G 2B7, CanadaPurpose. To compare preemptive multimodal analgesia (PMMA) without femoral nerve blocks (FNB) to PMMA including FNB following total knee arthroplasty (TKA). Methods. In a prospective, controlled pilot study, subjects with noninflammatory arthritis undergoing TKA and a short postoperative stay received either PMMA + FNB (FNB group; n=19) or PMMA only (PMMA group; n=20). No preoperative group differences were noted. Evaluations occurred in hospital and at 2, 6, and 12 weeks postoperatively. The primary outcome (knee flexion) was measured on day two postoperatively. Rehabilitation indices, pain, analgesic use, and length of stay (LOS) were also measured. Results. All subjects completed the study. The only significant group differences were quadriceps motor blocks in the FNB group (P<0.001). No significant differences were noted in ROM, pain levels, analgesic use, or hospital LOS. Conclusion. Other than the quadriceps motor block, no group differences were noted; both achieved satisfactory analgesia. Best postoperative pain management strategies when following a short hospital stay program are still unclear.http://dx.doi.org/10.1100/2012/273821
spellingShingle Lauren A. Beaupre
D. Bill C. Johnston
Sherry Dieleman
Ban Tsui
Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
The Scientific World Journal
title Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
title_full Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
title_fullStr Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
title_full_unstemmed Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
title_short Impact of a Preemptive Multimodal Analgesia plus Femoral Nerve Blockade Protocol on Rehabilitation, Hospital Length of Stay, and Postoperative Analgesia after Primary Total Knee Arthroplasty: A Controlled Clinical Pilot Study
title_sort impact of a preemptive multimodal analgesia plus femoral nerve blockade protocol on rehabilitation hospital length of stay and postoperative analgesia after primary total knee arthroplasty a controlled clinical pilot study
url http://dx.doi.org/10.1100/2012/273821
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