Patient-reported outcomes after femoral nerve block versus periarticular injections in patients undergoing total knee arthroplasty: A randomized controlled study

Background: Total Knee Arthroplasty (TKA) is one of the most advanced surgical solutions for pain relief and mobility improvement in patients with end stage osteoarthritis. TKA patients experience severe postoperative pain. Recently, peripheral nerve blockade and Peri or intra-articular injections have been used successfully with fewer side effects when compared to the conventional analgesic techniques. Measuring quality of recovery (QoR) using QoR-15 scale is considered as an accepted and efficient scale for clarification the success of surgery and anaesthesia. Materials and Methods: One hundred and thirty adult patients scheduled for TKA were randomized into 2 groups: Femoral nerve block (FNB) group and periarticular injections (PAI) group. All patients completed the QoR before or on the day of surgery and at the end of the first post-operative day. Postoperative pain scores, opiod consumption and adverse effects of the drugs and techniques were also measured. Results: Periarticular injections resulted in better analgesia at rest and on movement and less postoperative morphine consumption during the first 24 h postoperatively when compared to femoral nerve block. Global QoR-15 score was significantly higher in PAI when compared to FNB group. Conclusion: Periarticular injection of local anesthetics provides better quality of recovery and sufficient level of analgesia than does single shot femoral nerve block for patients undergoing total knee arthroplasty in early postoperative period. Keywords: Quality of recovery, Peri-articular injections, Total knee arthroplasty, Femoral nerve block.