Resumo

REINA, M. et al. Postoperative analgesia after knee arthroplasty through continuous femoral blockage with ropivacaine. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.1, pp.21-25. ISSN 1134-8046.

Introduction: The aim of this study was to determine the degree of pain and satisfaction after surgery of patients that received analgesia through continuous femoral blockage for total knee arthroplasty. Material and method: ASA I-III patients diagnosed of gonarthrosis and undergoing total knee arthroplasty under intradural anaesthesia were included. In the recovery unit and under the residuary effects of intradural anaesthesia, a catheter was placed near the femoral nerve, with neurostimulation. An initial bolus of 30 ml of ropivacaine 0.375% was administered, followed by continuous infusion of ropivacaine 0.125% 10 ml.h^-1 maintained during the first 48 hours of postoperative. The following variables were recorded: postoperative pain at 24 and 48 hours as assessed through EVA, pain location, presence of motor blockage, paresthesia-dysesthesia and side effects, as well as drugs used in case of inappropriate analgesia, technical difficulty and degree of satisfaction after 48 hours. Results: Eight patients were included, with an average weight and height of 78 kg and 157 cm, respectively. Pain severity recorded at 24 hours was EVA 0 (62.5%), EVA 5 (25%) and EVA 6 (12.5%). At 48 hours, 87.5% of patients had EVA 0 and 12,5%, EVA 4. All the patients with pain located it at the popliteal bone. Motor blockage was absent in all the patients. Paresthesia and nausea were present in 25% of patients at 24-48 hours. Intravenous NSAIs were used to complement the therapy in patients with inadequate anaesthesia, except for one patient in which a sciatic nerve blockage was performed using the anterior approach. The technique was easy to perform in 87.5% of patients and very difficult in 12.5%. Degree of satisfaction scored > 7 in all the patients. Conclusions: In our series, continuous 3-in-1 blockage provided effective analgesia in patients undergoing total knee arthroplasty. Furthermore, it is an easy-to-use technique that provided a high degree of satisfaction in the study patients.

Palavras-chave : Continuous femoral blockage; Ropivacaine; Postoperative analgesia.

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