Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study

Background: Total knee arthroplasty (TKA) has proven to be one of the most successful surgical treatments for end-stage osteoarthritis. However, certain patients are deemed unfit for arthroplasty. This study aimed to ascertain whether targeted peripheral nerve blocks could enhance quality of life, r...

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Main Authors: Dareen Al-Mehman, Shahad Alkhashrami, Mujeeb Ashraf
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Bali Journal of Anesthesiology
Subjects:
Online Access:https://doi.org/10.4103/bjoa.bjoa_32_25
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author Dareen Al-Mehman
Shahad Alkhashrami
Mujeeb Ashraf
author_facet Dareen Al-Mehman
Shahad Alkhashrami
Mujeeb Ashraf
author_sort Dareen Al-Mehman
collection DOAJ
description Background: Total knee arthroplasty (TKA) has proven to be one of the most successful surgical treatments for end-stage osteoarthritis. However, certain patients are deemed unfit for arthroplasty. This study aimed to ascertain whether targeted peripheral nerve blocks could enhance quality of life, reduce the need for analgesic medication, and enhance mobility and function. Patients and Methods: This prospective cohort and qualitative research included 50 patients over the age of 50 years, either waiting or unfit for TKA. Genicular nerve block (GNB) was carried out using 14 mL of bupivacaine 0.25% and 40 mg methylprednisolone and adductor canal block (ACB) using 9 mL of bupivacaine 0.25% and 20 mg methylprednisolone. Results: The numeric rating scale (NRS) for pain significantly lowered after 2 weeks, 3 months, and 6 months compared to scores at the beginning of treatment (P < 0.001). Oxford Knee Score was significantly higher after 2 weeks, 3 months, and 6 months compared to scores at the beginning of treatment (P < 0.001). Health-Related Quality of Life and Outcome scores started to improve in just 2 weeks after commencing the treatment and continued to improve over the coming months. The daily analgesia requirements showed a significant reduction in 11 patients, a decrease in 5 patients. Conclusion: Targeted peripheral nerve blocks for patients either waiting for total knee replacement or those who are unfit for total knee replacement offer an excellent choice in improving the quality of life, increasing mobility, and reducing daily analgesia consumption with a reasonable satisfaction of patients with the procedure.
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spelling doaj-art-e390e5a8c7dd4c1bae5cb7111da2540e2025-08-20T03:17:08ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762025-04-0192697410.4103/bjoa.bjoa_32_25Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational StudyDareen Al-MehmanShahad AlkhashramiMujeeb AshrafBackground: Total knee arthroplasty (TKA) has proven to be one of the most successful surgical treatments for end-stage osteoarthritis. However, certain patients are deemed unfit for arthroplasty. This study aimed to ascertain whether targeted peripheral nerve blocks could enhance quality of life, reduce the need for analgesic medication, and enhance mobility and function. Patients and Methods: This prospective cohort and qualitative research included 50 patients over the age of 50 years, either waiting or unfit for TKA. Genicular nerve block (GNB) was carried out using 14 mL of bupivacaine 0.25% and 40 mg methylprednisolone and adductor canal block (ACB) using 9 mL of bupivacaine 0.25% and 20 mg methylprednisolone. Results: The numeric rating scale (NRS) for pain significantly lowered after 2 weeks, 3 months, and 6 months compared to scores at the beginning of treatment (P < 0.001). Oxford Knee Score was significantly higher after 2 weeks, 3 months, and 6 months compared to scores at the beginning of treatment (P < 0.001). Health-Related Quality of Life and Outcome scores started to improve in just 2 weeks after commencing the treatment and continued to improve over the coming months. The daily analgesia requirements showed a significant reduction in 11 patients, a decrease in 5 patients. Conclusion: Targeted peripheral nerve blocks for patients either waiting for total knee replacement or those who are unfit for total knee replacement offer an excellent choice in improving the quality of life, increasing mobility, and reducing daily analgesia consumption with a reasonable satisfaction of patients with the procedure.https://doi.org/10.4103/bjoa.bjoa_32_25arthroplastybupivacainekneeprospective studiesquality of lifereplacement
spellingShingle Dareen Al-Mehman
Shahad Alkhashrami
Mujeeb Ashraf
Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
Bali Journal of Anesthesiology
arthroplasty
bupivacaine
knee
prospective studies
quality of life
replacement
title Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
title_full Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
title_fullStr Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
title_full_unstemmed Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
title_short Enhancing Quality of Life and Reducing Analgesic use with Targeted Nerve Blocks in Patients who are not Medically Fit for the Knee Arthroplasty: An Observational Study
title_sort enhancing quality of life and reducing analgesic use with targeted nerve blocks in patients who are not medically fit for the knee arthroplasty an observational study
topic arthroplasty
bupivacaine
knee
prospective studies
quality of life
replacement
url https://doi.org/10.4103/bjoa.bjoa_32_25
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AT mujeebashraf enhancingqualityoflifeandreducinganalgesicusewithtargetednerveblocksinpatientswhoarenotmedicallyfitforthekneearthroplastyanobservationalstudy