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Research Paper | Anaesthesiology | India | Volume 13 Issue 6, June 2024 | Rating: 6.4 / 10
Assessment of Postoperative Opioid - Free Analgesia in Total Knee Replacement Patients: An Observational Study of Ultrasound - Guided Single Injection 4 - in - 1 Nerve Block
Dr. Sai Om Mishra | Dr. Deepinder Kaur [2] | Dr. Narayan Acharya | Dr. Ritwik Dash
Abstract: Introduction: Lower limb surgeries necessitate optimal outcomes with minimal morbidity, highlighting the importance of central neuraxial and regional anesthesia techniques for reducing perioperative complications. Total Knee Replacement (TKR) surgery, vital for addressing advanced knee conditions, underscores the need for effective postoperative pain management beyond traditional opioid reliance. Methods: A prospective observational study was done. Eight ASA 1 and 2 TKR patients received an USG - guided 4in1 block. SAB with Inj Bupivacaine Heavy 0.5% was administered, and an epidural catheter was inserted for supplementary analgesia. Patients were positioned supine with the ipsilateral leg in Frog leg position. A high - frequency probe identified the vastus medialis, followed by visualization of the superficial femoral artery and genicular descending artery. Nerve to vastus medialis was targeted using PNS with 5ml mixture of Inj Bupivacaine 0.25% and Inj Dexmedetomedine. Subsequently, 35ml of the mixture was administered in - plane to the perivascular region, ensuring arterial displacement. Results: After 24 hours, patients reported pain scores ? 5, prompting IV Inj Paracetamol (15mg/kg). None required epidural or opioid rescue analgesia. Ambulation ranged from 8 to 12 hours post - procedure. Conclusion: The study indicates promising efficacy of USG - guided 4in1 block for TKR patients, yet highlights the necessity for further extensive research to validate and refine its long - term efficacy and safety.
Keywords: Lower limb surgeries, anesthesia techniques, Total Knee Replacement, postoperative pain management, USG - guided 4in1 block
Edition: Volume 13 Issue 6, June 2024,
Pages: 207 - 209