The Analgesia and Rehabilitation Effect of Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction_West China Medical Journal

Authors：

 LUOQui-ping ¹ , WANGJuan ¹ , LIAOMing-yi ¹ , LIZhi ¹ , ZHANGQian-wen ¹ , LIJian ²

1. Out-patient Department, Chengdu, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics;West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

Femoral nerve block; Anterior cruciate ligament reconstruction; Analgesia; Rehabilitation

DOI：

10.7507/1002-0179.20150582

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Objective To study the analgesia and rehabilitation effect of femoral nerve block after anterior cruciate ligament reconstruction (ACLR). Methods During June to September 2014, 62 patients who were scheduled to undergo ACLR were randomly divided into two groups:femoral nerve block group (n=31) and control group (n=31). All the patients were given celecoxib 200 mg (twice per day) three days before surgery. Patients in the femoral nerve block group were given a single-injection femoral nerve block (SFNB) half an hour before surgery (ropivacaine 0.75%, 30 mL), Both of the two groups underwent ice therapy after surgery. The visual analogue scale (VAS) scores, knee joint range of motion, the muscle strength of quadriceps femoris, the side effects, complications and infection rate were recorded after the operation. Results The VAS scores were significantly lower in the femoral nerve block group within 2 hours to 7 days after surgery (P<0.05), and the use of morphine was less than the control group in all the time points with statistical significance (P<0.05). The muscle strength of quadriceps femoris was significantly weaker in the femoral nerve block group than the control group in the first 12 hours (P<0.05). The side effects and infection rate between the two group had no significant difference (P>0.05). Conclusion The femoral nerve block in anterior cruciate ligament reconstruction before surgery has a good effect on postoperative analgesia and rehabilitation, which is worth popularizing and applying.

Citation： LUOQui-ping, WANGJuan, LIAOMing-yi, LIZhi, ZHANGQian-wen, LIJian. The Analgesia and Rehabilitation Effect of Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction. West China Medical Journal, 2015, 30(11): 2050-2053. doi: 10.7507/1002-0179.20150582 Copy

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3.	Noonan B, Chung KS. A practical review of the mechanisms of pain and pain management following ACL reconstruction[J]. Orthopedics, 2006, 29(11):999-1005.
4.	Wulf H, Loewe J, Gnutzmann KH, et al. Femoral nerve block with ropivacaine or bupivacaine in day case anterior crucial ligament reconstruction[J]. Acta Anaesthesiol Scand, 2010, 54(4):414-420.
5.	Viscusi ER, Parvizi J, Tarity TD. Developments in spinal and epidural anesthesia and nerve blocks for total joint arthroplasty:what is new and exciting in pain management[J]. Instr Course Lect, 2007, 56:139-145.
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7.	Kimmel SE, Berlin JA, Reilly M, et al. Patients exposed to rofecoxib and celecoxib have different odds of nonfatal myocardial infarction[J]. Ann Intern Med, 2005, 142(3):157-164.
8.	Brophy JM. Celecoxib and cardiovascular risks[J]. Expert Opin Drag Saf, 2005, 4(6):1005-1015．.
9.	Tali M, Maaroos J. Lower limbs function and pain relationships after unilateral total knee arthroplasty[J]. Int J Rehabil Res, 2010, 33(3):264-267.
10.	Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia:a systematic review[J]. J Pain, 2002, 3(3):159-180.
11.	Brokelman RB, Van Loon CJ, Rijnberg WJ. Patient versus surgeon satisfaction after total hip arthroplasty[J]. J Bone Joint Surg Br, 2003, 85(4):495-498.
12.	Deleo JA. Basic science of pain[J]. J Bone Joint Surg Am, 2006, 88A(2):58-62.

1. Schuster M, Engelhardt L, Erler W, et al. Levobupivacaine vs. pivacaine for continuous femoral anal gesia after anterior cruciate ligament reconstruction[J]. Schmerz, 2011, 25(1):62-68.
2. Higgins LD, Taylor MK, Park DA, et al. Reliability and validity of the International Knee Documentation Committee (IKDC) Subjective Knee Form[J]. Joint Bone Spine, 2007, 74(6):594-599.
3. Noonan B, Chung KS. A practical review of the mechanisms of pain and pain management following ACL reconstruction[J]. Orthopedics, 2006, 29(11):999-1005.
4. Wulf H, Loewe J, Gnutzmann KH, et al. Femoral nerve block with ropivacaine or bupivacaine in day case anterior crucial ligament reconstruction[J]. Acta Anaesthesiol Scand, 2010, 54(4):414-420.
5. Viscusi ER, Parvizi J, Tarity TD. Developments in spinal and epidural anesthesia and nerve blocks for total joint arthroplasty:what is new and exciting in pain management[J]. Instr Course Lect, 2007, 56:139-145.
6. Coda BA, Hill HF, Hunt EB, et al. Cognitive and motor function impairments during continuous opioid analgesic infusions[J]. Hum Psychopharmacol, 1993, 8(8):383-400.
7. Kimmel SE, Berlin JA, Reilly M, et al. Patients exposed to rofecoxib and celecoxib have different odds of nonfatal myocardial infarction[J]. Ann Intern Med, 2005, 142(3):157-164.
8. Brophy JM. Celecoxib and cardiovascular risks[J]. Expert Opin Drag Saf, 2005, 4(6):1005-1015．.
9. Tali M, Maaroos J. Lower limbs function and pain relationships after unilateral total knee arthroplasty[J]. Int J Rehabil Res, 2010, 33(3):264-267.
10. Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia:a systematic review[J]. J Pain, 2002, 3(3):159-180.
11. Brokelman RB, Van Loon CJ, Rijnberg WJ. Patient versus surgeon satisfaction after total hip arthroplasty[J]. J Bone Joint Surg Br, 2003, 85(4):495-498.
12. Deleo JA. Basic science of pain[J]. J Bone Joint Surg Am, 2006, 88A(2):58-62.

West China Medical Journal

The Analgesia and Rehabilitation Effect of Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction

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