The Effect of Continuous Peripheral Nerve Catheters on Postoperative Orthopedic Pain
Abstract
Continuous peripheral femoral nerve block (CFNB) has been proposed as an effective pain management modality, providing pain relief with fewer side effects compared to opioid medications. The purpose of this thesis was to evaluate the effectiveness of the use of a peripheral nerve block on pain for patients undergoing total knee arthroplasty. Data was collected retrospectively utilizing the patient medical record, comparing target pain score, actual pain scores, number of additional doses of narcotic analgesia utilized, and knee flexion achieved for each of three groups: continuous femoral nerve block, single injection nerve block and no nerve block. Results indicated patients with continuous femoral nerve blocks used fewer doses of pain medication on the first day postoperatively, however took more pain medication doses on days two - four, followed by patients with single injections, and no block patients took fewest medication doses of the groups. Knee flexion in CFNB group showed higher degrees on day one postoperatively, followed by no block patients then single block patients. However, by day three no block patients achieved higher knee flexion, followed by CFNB, then single injection. CFNB group had lower actual pain scores on day one but gradually increased by day four. Single block patients had similar results. The no block patients had gradual decrease in pain scores, achieving the lowest pain score on day four. This study would indicate that the most effective pain management was to not have a femoral block, continuous or single injection, and to use traditional pain management protocols.