Femoral and Epidural Block After Total Knee Arthroplasty

Study Overview
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Brief Summary
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Total knee prosthetic replacement causes severe postoperative pain. Various analgesic techniques have been used in pain control. Comparison of epidural and femoral nerve block is lacking, furthermore effect on chronic pain is unclear. The investigators aimed to compare the effects of epidural and femoral block on acute and chronic postoperative pain.

Detailed Description
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Background and aim Total knee prosthetic replacement causes severe postoperative pain. Various analgesic techniques have been used in pain control. Comparison of epidural and femoral nerve block is lacking, furthermore effect on chronic pain is unclear. The investigators aimed to compare the effects of epidural and femoral block on acute and chronic postoperative pain. Methods The study was of randomized, prospective, and double-blind design and was conducted with 80 patients who had undergone total knee prosthetic replacement surgery with the insertion of a femoral nerve block or epidural block catheter to initiate postoperative analgesia. One-sided spinal anesthesia was performed in all the patients. Postoperative pain control was achieved with the administration via catheter using bupivacaine for patient-controlled analgesia. Acute postoperative pain was evaluated in the first 24 hours and chronic postoperative pain in the 1st and 3rd months following surgery. The anxiety/depression scale was used to assess anxiety and depression, the SF 12 test was used to evaluate quality of life, and the DN4 test was employed at patient visits at the 1st and 3rd months.

Official Title
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COMPARISON OF CONTINUOUS FEMORAL NERVE BLOCK AND PATIENT CONTROLLED EPIDURAL ANALGESIA AFTER TOTAL KNEE ARTHROPLASTY

Conditions
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Acute Postoperative Pain, Chronic Postoperative Pain

Intervention / Treatment
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* Other: DN4 test
* Other: The SF 12 test
* Other: HAD scale
* Other: Visual analogue score
* Procedure: femoral block
* Procedure: epidural block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of total knee arthroplasty Exclusion Criteria: Patients with pain syndromes Patients using routinely medications for pain

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: epidural block<br>Visual anlogue score vas used to evaluate pain. The anxiety/depression scale (HAD) was used to assess anxiety and depression. The SF 12 test (SHORT FORM 12) was used to evaluate quality of life. The DN4 test was used to evaluate neuropathic pain. | Other: DN4 test<br>* The DN4 test was used to evaluate neuropathic pain.<br>Other: The SF 12 test<br>* The SF 12 test (SHORT FORM 12) was used to evaluate quality of life.<br>* Other names: SHORT FORM 12;Other: HAD scale<br>* The anxiety/depression scale (HAD) was used to assess anxiety and depression.<br>* Other names: The anxiety/depression scale;Other: Visual analogue score<br>* Visual analogue score vas used to evaluate pain.<br>* Other names: VAS score;Procedure: epidural block<br> <br> |
| Active Comparator: femoral block<br>Visual anlogue score vas used to evaluate pain. The anxiety/depression scale (HAD) was used to assess anxiety and depression. The SF 12 test (SHORT FORM 12) was used to evaluate quality of life. The DN4 test was used to evaluate neuropathic pain. | Other: DN4 test<br>* The DN4 test was used to evaluate neuropathic pain.<br>Other: The SF 12 test<br>* The SF 12 test (SHORT FORM 12) was used to evaluate quality of life.<br>* Other names: SHORT FORM 12;Other: HAD scale<br>* The anxiety/depression scale (HAD) was used to assess anxiety and depression.<br>* Other names: The anxiety/depression scale;Other: Visual analogue score<br>* Visual analogue score vas used to evaluate pain.<br>* Other names: VAS score;Procedure: femoral block<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Persistent surgical pain after total knee arthroplasty assessed by VAS scale |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The anxiety and depression was evaluated with Hospital anxiety and depression scale. |  | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic postoperative pain, total knee arthroplasty, femoral block, We aimed to compare the effects of epidural and femoral block on acute and chronic postoperative pain.