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Canadian Journal of Anaesthesia

, Volume 46, Issue 10, pp 919–924 | Cite as

Femoral nerve block and ketorolac in patients undergoing anterior cruciate ligament reconstruction

  • Philip Peng
  • Andrew Claxton
  • Frances Chung
  • Vincent Chan
  • Anthony Miniaci
  • Ananthan Krishnathas
Reports of Investigation

Abstract

Purpose

The primary objective was to evaluate the analgesic effectiveness of femoral nerve block and ketorolac following ACL reconstruction. The secondary objective was to examine their effects on recovery milestones.

Methods

Prior to standard general anesthesia, 90 patients were randomized into three groups of preoperative treatment: 1) femoral nerve block (15 mL bupivacaine 0.5%) and 1 mL normal salineiv (FNB group); 2) placebo femoral nerve block (15 mL normal saline) and 30 mg (1 mL) ketorolaciv (KT group); 3) placebo femoral nerve block (15 mL normal saline) and 1 mL normal salineiv (PL group). Postoperatively, pain was assessed by visual analogue score, demand and consumption of morphine via patient-controlled analgesia pump. The times for patients to tolerate oral fluid, food, sit up, ambulate and void were also noted.

Results

Morphine consumption within one hour, three hours and until POD 1 in the FNB group was lower than the PL group (7 ± 6, 11 ± 9, 27 ± 23 mgvs 13 ± 5, 20 ± 9, 49 ± 28 mg respectively), whereas only that within one hour in the KT group was lower than the PL group. Pain score was lower in FNB and KT groups in the first postoperative hour than in the PL group (P < 0.05). There were no differences among the three groups in the times to meet recovery milestone and discharge criteria.

Conclusion

Femoral nerve block provides superior analgesia than placebo for ACL reconstruction but was insufficient to facilitate early recovery.

Keywords

Morphine Anterior Cruciate Ligament Reconstruction Ketorolac Visual Analog Score Morphine Consumption 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

D’abord, évaluer l’efficacité analgésique du blocage du nerf fémoral et de l’administration de kétorolac à la suite d’une reconstruction du ligament croisé antérieur (LCA). Ensuite, examiner leurs effets sur les étapes de la récupération.

Méthode

Avant l’anesthésie générale standard, 90 patients ont été répartis en trois groupes: 1) blocage du nerf fémoral (15 mL de bupivacaïne 0,5 %) et 1 mL de solution saléeiv (groupe BNF); 2) un placebo du blocage du nerf fémoral (15 mL de solution salée) et 30 mg (1 mL) de kétorolaciv (groupe KT); 3) un placebo du blocage nerveux (15 mL de solution salée) et 1 mL de solution saléeiv (groupe PL). La douleur postopératoire a été évaluée selon l’échelle visuelle analogue, la demande et la consommation de morphine au moyen d’une pompe d’analgésie contrôlée par le patient. On a aussi noté le moment de la prise de liquide et de nourriture, le moment où le patient pouvait s’asseoir et marcher et celui de la première miction.

Résultats

La consommation de morphine pendant la première heure, les trois premières heures et jusqu’à la fin du premier jour postopératoire a été plus faible dans le groupe BNF que dans le groupe PL (7 ± 6, 11 ± 9, 27 ± 23 mgvs 13 ± 5, 20 ± 9, 49 ± 28 mg respectivement), mais ce n’est que pendant la première heure qu’elle a été plus faible dans le groupe KTvs PL. La douleur a été moins intense dans les groupes BNF et KT que dans le groupe PL pendant la première heure postopératoire (P < 0,05). Il n’y a pas eu de différence intergroupe quant au moment des différentes étapes de la récupération et de la conformité aux critères de sortie.

Conclusion

Le blocage du nerf fémoral fournit une analgésie supérieure au placebo dans le cas d’une reconstruction du LCA, mais ne permet pas une récupération plus rapide.

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Copyright information

© Canadian Anesthesiologists 1999

Authors and Affiliations

  • Philip Peng
    • 1
  • Andrew Claxton
    • 3
  • Frances Chung
    • 1
  • Vincent Chan
    • 1
  • Anthony Miniaci
    • 2
  • Ananthan Krishnathas
    • 1
  1. 1.Department of AnesthesiaToronto Hospital, University of TorontoTorontoCanada
  2. 2.Department of Orthopedic SurgeryToronto Hospital, University of TorontoTorontoCanada
  3. 3.Department of AnaesthesiaNew Cross HospitalWolverhamptonUK

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