[Comparison of postoperative pain relief by continuous femoral nerve block and that by epidural block during physiotherapy after minimally invasive surgery of total knee arthroplasty and uni-condylar knee arthroplasty].

BACKGROUND: We compared postoperative pain relief during physiotherapy after minimally invasive surgery (MIS) of total knee arthroplasty (TKA) and unicondylar arthroplasty (UKA). METHODS: Ninety-five patients scheduled for TKA or UKA under spinal anesthesia were divided into continuous femoral nerve block (0.1-0.12% ropivacaine 4 ml x hr(-1)) combined with a single sciatic block (Group CFNB) and epidural block (0.1-0.19% ropivacaine 4 ml x hr(-1)) combined with a single femoral block (Group EP). Visual analogue scale (VAS) at rest, walking, maximal knee flexion, extension, and maximal pain on POD 1 were recorded. Patient's satisfaction of analgesia and supplemental analgesics on POD 1 were recorded. We compared VAS and satisfaction of TKA with UKA during CFNB or EP. RESULTS: VAS at physiotherapy was higher than VAS at rest. VAS at maximal knee flexion was higher than VAS at rest, walking or maximal knee extension in UKA of Group CFNB (n = 29) or EP (n = 19). VAS at flexion and extension were higher than VAS at walk- ing in TKA of Group CFNB (n = 20) or EP (n = 27). VAS, patient's satisfaction and supplemental analgesics on POD 1 were comparable in both groups. CONCLUSIONS: VAS at physiotherapy after TKA or UKA during CFNB or EP was very severe than VAS at rest.