Jan Mick Jensen

Analgesia of Combined Femoral Triangle and Obturator Nerve Blockade Is Superior to Local Infiltration Analgesia after Total Knee Arthroplasty with High-Dose Intravenous Dexamethasone

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Standard

Analgesia of Combined Femoral Triangle and Obturator Nerve Blockade Is Superior to Local Infiltration Analgesia after Total Knee Arthroplasty with High-Dose Intravenous Dexamethasone. / Runge, Charlotte; Jensen, Jan Mick; Clemmesen, Louise; Knudsen, Henriette Bach; Holm, Carsten; Børglum, Jens; Bendtsen, Thomas Fichtner.

I: Regional Anesthesia and Pain Medicine, Bind 43, Nr. 4, 01.05.2018, s. 352-356.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{3f544d4d0ad24384bf6074653ac08022,
title = "Analgesia of Combined Femoral Triangle and Obturator Nerve Blockade Is Superior to Local Infiltration Analgesia after Total Knee Arthroplasty with High-Dose Intravenous Dexamethasone",
abstract = "Background and Objectives High-dose intravenous dexamethasone reduces the postoperative opioid requirement and is often included in the multimodal analgesia strategy after total knee arthroplasty (TKA). Combined obturator nerve and femoral triangle blockade (OFB) reduces the opioid consumption and pain after TKA better than local infiltration analgesia (LIA). The question is whether preoperative high-dose intravenous dexamethasone would cancel out the superior analgesic effect of OFB compared with LIA. The aim was to evaluate the analgesic effect of OFB versus LIA after TKA when all patients received high-dose intravenous dexamethasone. Methods Eighty-two patients were randomly assigned either to OFB or LIA after primary unilateral TKA. All patients received 16 mg dexamethasone. Primary outcome was morphine consumption via patient-controlled analgesia during the first 20 postoperative hours. Secondary outcomes were pain, nausea, dizziness, and length of hospital stay. Results Seventy-four patients were included in the analysis. Median total intravenous morphine consumption during the first 20 postoperative hours was 6 mg (interquartile range [IQR], 2-18 mg) in the OFB group and 20 mg (IQR, 12-28 mg) in the LIA group. The 14-mg difference (95% confidence interval, 6.4-18.0 mg) was significant (P < 0.001). There was no difference in pain score at rest at 20 hours postoperatively: 2 (IQR, 1-4) in the OFB group and 3 (IQR, 2-5) in the LIA group. Conclusions Combined OFB reduces morphine consumption better than LIA after TKA even when all patients received high-dose intravenous dexamethasone.",
author = "Charlotte Runge and Jensen, {Jan Mick} and Louise Clemmesen and Knudsen, {Henriette Bach} and Carsten Holm and Jens B{\o}rglum and Bendtsen, {Thomas Fichtner}",
year = "2018",
month = may,
day = "1",
doi = "10.1097/AAP.0000000000000731",
language = "English",
volume = "43",
pages = "352--356",
journal = "Regional Anesthesia and Pain Medicine",
issn = "1098-7339",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "4",

}

RIS

TY - JOUR

T1 - Analgesia of Combined Femoral Triangle and Obturator Nerve Blockade Is Superior to Local Infiltration Analgesia after Total Knee Arthroplasty with High-Dose Intravenous Dexamethasone

AU - Runge, Charlotte

AU - Jensen, Jan Mick

AU - Clemmesen, Louise

AU - Knudsen, Henriette Bach

AU - Holm, Carsten

AU - Børglum, Jens

AU - Bendtsen, Thomas Fichtner

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background and Objectives High-dose intravenous dexamethasone reduces the postoperative opioid requirement and is often included in the multimodal analgesia strategy after total knee arthroplasty (TKA). Combined obturator nerve and femoral triangle blockade (OFB) reduces the opioid consumption and pain after TKA better than local infiltration analgesia (LIA). The question is whether preoperative high-dose intravenous dexamethasone would cancel out the superior analgesic effect of OFB compared with LIA. The aim was to evaluate the analgesic effect of OFB versus LIA after TKA when all patients received high-dose intravenous dexamethasone. Methods Eighty-two patients were randomly assigned either to OFB or LIA after primary unilateral TKA. All patients received 16 mg dexamethasone. Primary outcome was morphine consumption via patient-controlled analgesia during the first 20 postoperative hours. Secondary outcomes were pain, nausea, dizziness, and length of hospital stay. Results Seventy-four patients were included in the analysis. Median total intravenous morphine consumption during the first 20 postoperative hours was 6 mg (interquartile range [IQR], 2-18 mg) in the OFB group and 20 mg (IQR, 12-28 mg) in the LIA group. The 14-mg difference (95% confidence interval, 6.4-18.0 mg) was significant (P < 0.001). There was no difference in pain score at rest at 20 hours postoperatively: 2 (IQR, 1-4) in the OFB group and 3 (IQR, 2-5) in the LIA group. Conclusions Combined OFB reduces morphine consumption better than LIA after TKA even when all patients received high-dose intravenous dexamethasone.

AB - Background and Objectives High-dose intravenous dexamethasone reduces the postoperative opioid requirement and is often included in the multimodal analgesia strategy after total knee arthroplasty (TKA). Combined obturator nerve and femoral triangle blockade (OFB) reduces the opioid consumption and pain after TKA better than local infiltration analgesia (LIA). The question is whether preoperative high-dose intravenous dexamethasone would cancel out the superior analgesic effect of OFB compared with LIA. The aim was to evaluate the analgesic effect of OFB versus LIA after TKA when all patients received high-dose intravenous dexamethasone. Methods Eighty-two patients were randomly assigned either to OFB or LIA after primary unilateral TKA. All patients received 16 mg dexamethasone. Primary outcome was morphine consumption via patient-controlled analgesia during the first 20 postoperative hours. Secondary outcomes were pain, nausea, dizziness, and length of hospital stay. Results Seventy-four patients were included in the analysis. Median total intravenous morphine consumption during the first 20 postoperative hours was 6 mg (interquartile range [IQR], 2-18 mg) in the OFB group and 20 mg (IQR, 12-28 mg) in the LIA group. The 14-mg difference (95% confidence interval, 6.4-18.0 mg) was significant (P < 0.001). There was no difference in pain score at rest at 20 hours postoperatively: 2 (IQR, 1-4) in the OFB group and 3 (IQR, 2-5) in the LIA group. Conclusions Combined OFB reduces morphine consumption better than LIA after TKA even when all patients received high-dose intravenous dexamethasone.

UR - http://www.scopus.com/inward/record.url?scp=85046350741&partnerID=8YFLogxK

U2 - 10.1097/AAP.0000000000000731

DO - 10.1097/AAP.0000000000000731

M3 - Journal article

C2 - 29346228

AN - SCOPUS:85046350741

VL - 43

SP - 352

EP - 356

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

SN - 1098-7339

IS - 4

ER -