A prospective double blinded randomized study of anterior cruciate ligament reconstruction with hamstrings tendon and spinal anesthesia with or without femoral nerve block

A prospective double blinded randomized study of anterior cruciate ligament reconstruction with hamstrings tendon and spinal anesthesia with or without femoral nerve block

Author Astur, Diego Costa Autor UNIFESP Google Scholar
Aleluia, Vinicius Google Scholar
Veronese, Ciro Google Scholar
Astur, Nelson Google Scholar
Oliveira, Saulo Gomes Google Scholar
Arliani, Gustavo Goncalves Autor UNIFESP Google Scholar
Badra, Ricardo Google Scholar
Kaleka, Camila Cohen Google Scholar
Amaro, Joicemar Tarouco Google Scholar
Cohen, Moises Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Inst Cohen
Univ Tennessee
Santa Casa Sch Med & Hosp
Abstract Background: Current literature supports the thought that anesthesia and analgesia administered perioperatively for an anterior cruciate ligament (ACL) reconstruction have a great influence on time to effective rehabilitation during the first week after hospital discharge.Purpose: the aim of this study is to answer the research question is there a difference in clinical outcomes between the use of a femoral nerve block with spinal anesthesia versus spinal analgesia alone for people undergoing ACL reconstruction?Methods: ACL reconstruction with spinal anesthesia and patient sedation (Group one); and spinal anesthesia with patient sedation and an additional femoral nerve block (Group two). Patients were re-evaluated for pain, range of motion (ROM), active contraction of the quadriceps, and a Functional Independence Measure (FIM) scoring scale.Results: Spinal anesthesia with a femoral nerve block demonstrates pain relief 6 h after surgery (VAS 0.37; p = 0.007). From the third (VAS = 4.56; p = 0.028) to the seventh (VAS = 2.87; p = 0.05) days after surgery, this same nerve blockage delivered higher pain scores. Patients had a similar progressive improvement on knee Joint range of motion with or without femoral nerve block (p < 0.002). Group one and two had 23.75 and 24.29 degrees 6 h after surgery and 87.81 and 85.36 degrees of knee flexion after 48 h post op.Conclusion: Spinal anesthesia associated with a femoral nerve block had no additional benefits on pain control after the third postoperative day. There were no differences between groups concerning ability for knee flexion and to complete daily activities during postoperative period. (C) 2014 Elsevier B.V. All rights reserved.
Keywords Knee
ACL reconstruction
Femoral nerve block
Randomized clinical trial
Anesthesia
Language English
Date 2014-10-01
Published in Knee. Amsterdam: Elsevier B.V., v. 21, n. 5, p. 911-915, 2014.
ISSN 0968-0160 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 911-915
Origin http://dx.doi.org/10.1016/j.knee.2014.06.003
Access rights Closed access
Type Article
Web of Science ID WOS:000343341900008
URI http://repositorio.unifesp.br/handle/11600/38293

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