To evaluate the use of femoral nerve block for post-operative total knee arthroplasty patients and the purpose determine if femoral nerve block improves patient pain control, increase mobilization and decrease length of stay. Design: Descriptive retrospective review at Iredell Memorial Hospital. Patients: 159 patients scheduled for elective TKA after other medical alternatives failed, over a 6 month period (June 2014-December 2014). A total of 137 patients met the inclusion criteria: 1) knee pain 2) stiffness 3) reduced flexibility 4) osteoarthriitis 5) total knee arthroplasty. The study group was 137 patient, 22 patient excluded from study. The study group (N=137) received single dose of bupropivaine or roprovicaine via sciatic and continuous femoral nerve block, the group also received orthopedic surgical protocol order set that included by mouth pain medication for break, threw pain control. The location, position and needle size was documented on the report sheet that was revised 05/2014. The anesthesiologist used an ultrasound to visualize needle placement, this was verified by the surgeon and the image recorded for chart. Outcome measurements: included the type of anesthesia administered during the procedure (FNB), pain score and length of stay at Iredell Memorial Hospital. The study group demonstrated decreased pain scores on first post-operative day, averaging 2.89, the study group length of stay m=3.47 and patient was ambulating on day m=2.6, with assistive devices. The study group was not compared to other anesthesia because the patients was ruled out during pre-operative assessment at orthopedic office visit. The results in consistent with other literature review demonstrating use of femoral nerve block, decreases the length of stay, increase mobilization and improves patient pain.
Introduction.
Peri-operative pain management for total knee replacement is yet to be satisfactorily optimized.