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Title: A prospective double blinded randomized study of anterior cruciate ligament reconstruction with hamstrings tendon and spinal anesthesia with or without femoral nerve block
Authors: Astur, Diego Costa [UNIFESP]
Aleluia, Vinicius
Veronese, Ciro
Astur, Nelson
Oliveira, Saulo Gomes
Arliani, Gustavo Goncalves [UNIFESP]
Badra, Ricardo
Kaleka, Camila Cohen
Amaro, Joicemar Tarouco
Cohen, Moises [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Inst Cohen
Univ Tennessee
Santa Casa Sch Med & Hosp
Keywords: Knee
ACL reconstruction
Femoral nerve block
Randomized clinical trial
Issue Date: 1-Oct-2014
Publisher: Elsevier B.V.
Citation: Knee. Amsterdam: Elsevier B.V., v. 21, n. 5, p. 911-915, 2014.
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.
ISSN: 0968-0160
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