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Single Shot Femerol Nerve vs. Non Femerol Nerve Block in Total Knee Arthroplasty
AuthorGoins, Theresa L.
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AB STRACTPost-operative pain has a substantial impact on initiation of ambulation and timely discharge. Alternative pain treatment modalities are available to expedite or improve functional status and the patients overall anesthetic experience. A retrospective comparative study was conducted to examine the experiences of 207 patients who underwent unilateral total knee arthroplasty (TKA). This study compared patients who received a single shot femoral nerve block (FNB) prior to surgery (N=37) to those who did not (NFNB) (N=170). Several t-test analyses were used to determine statistical significance between sample means comparing length of stay, narcotic usage and pain scores of FNB subjects and NFNB subjects. Two chi-square analyses were conducted to determine whether (a) adverse side effects of narcotics are independent of a FNB, and (b) whether time of ambulation is independent of a FNB. Findings were not statistically significant for adverse side effects of narcotics (X2 = 0.258, df = 3) and early ambulation (X2 = 0.970, df = 3). Pain scores at measured intervals of 12 hour (p = 0.539), 24 hours (p = 0.776), 36 hours (p = 0.673) 48 hours (p = 0.212) and 60 hours (p = 0.923) were also not significant. Length of stay was not significant (p = 0.349) between FNB and NFNB subjects. FNB subjects received 23.13 mg or 14% less narcotics than NFNB subjects (p = 0.051). Subjects with a FNB also reported 22% less nausea and vomiting. The study concludes that subjects who received a single shot FNB prior to surgery used fewer narcotics for TKA compared to NFNB subjects. This study rejects the hypothesis that single shot FNB decreases length of hospital stay, initiation of ambulation, pain scores and adverse drug effects. Future studies may require a larger sample size to produce different outcomes in order to support the hypothesis of this study. Level of Evidence: Level lll. Retrospective cohort study16Key words: total knee arthroplasy, femoral nerve block, pain scores, ambulation, length of stay, narcotics