Total knee arthroplasty surgery is preferred in the treatment of osteoarthritis and causes severe postoperative pain. In this study, we aimed to investigate the effects of lumbar erector spina plan block and adductor canal block on postoperative pain and quadriceps muscle strength in patients who underwent total knee arthroplasty with spinal anesthesia.
In a prospective, randomized study; Medeniyet University Faculty of Medicine Göztepe Prof. Dr. Forty patients who underwent total knee arthroplasty surgery at Süleyman Yalçın City Hospital were divided into two groups. After the surgery was completed, erector spina plane block was applied to Group E (n=20) patients with 20 ml of 0.25% bupivacaine from the operated side L3-L4 level, while in Group A (n=20) patients, in the area where the sartorius muscle crosses the adductor magnus muscle, it was lateral to the superficial femoral artery. Adductor canal block was applied to the adductor canal with 20 ml of 0.5% bupivacaine. All patients were administered 1 gr paracetamol and 75 mg diclofenac sodium when their pain started in the orthopedic ward. Numerical pain score and quadriceps muscle strength were evaluated during the 48-hour follow-up of the patients. When the pain score was 4 and above, 50 mg pethidine hydrochloride was administered.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
After the necessary asepsis and antisepsis procedures, the linear ultrasound probe was placed parasagittally 2-3 cm lateral to the spinous process at the L3 or L4 level and the transverse process was visualized. The peripheral block needle (85 mm B Braun Stimuplex A) was advanced in plane up to the transverse process and 10 ml 0.5% bupivacaine hydrochloride 10 ml 0.9% isotonic NaCl mixture was applied on the erector spina muscle.
After the necessary asepsis and antisepsis procedures, the linear ultrasound probe was placed in the middle between the medial condyle and the SIAS, and the superficial femoral artery (FSA) was visualized under the sartorius muscle. By following the FSA distally, the point where the sartorius muscle crosses the adductor magnus muscle, which is the beginning of the adductor canal, was found and the saphenous nerve was visualized hyperechoic in the anterolateral aspect of the FSA. 20 cc 0.5% bupivacaine hydrochloride was applied
Istanbul Medeniyet University Goztepe Suleyman Yalcın City Hospital
Istanbul, Turkey (Türkiye)
Postoperative pain 30 minute
Visual anolog score (1-10)
Time frame: 30. min.
Postoperative pain 1. hour
Visual anolog score (1-10)
Time frame: 1. hour
Postoperative pain 2. hour
Visual anolog score (1-10)
Time frame: 2. hour
Postoperative pain 6. hour
Visual anolog score (1-10)
Time frame: 6. hour
Postoperative pain 12. hour
Visual anolog score (1-10)
Time frame: 12. hour
Postoperative pain 24. hour
Visual anolog score (1-10)
Time frame: 24. hour
Postoperative pain 36. hour
Visual anolog score (1-10)
Time frame: 36. hour
Postoperative pain 48. hour
Visual anolog score (1-10)
Time frame: 48. hour
Opioid consuption 30. min.
Petidine (mg)
Time frame: 30. min.
Opioid consuption 1. hour
Petidine (mg)
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Time frame: 1. hour
Opioid consuption 2. hour
Petidine (mg)
Time frame: 2. hour
Opioid consuption 6. hour
Petidine (mg)
Time frame: 6. hour
Opioid consuption 12. hour
Petidine (mg)
Time frame: 12. hour
Opioid consuption 24. hour
Petidine (mg)
Time frame: 24. hour
Opioid consuption 36. hour
Petidine (mg)
Time frame: 36. hour
Opioid consuption 48. hour
Petidine (mg)
Time frame: 48. hour