Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty

무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향

  • Choi, Yun Suk (Department of Anesthesiology and Pain Medicine, Jeju National University Hospital) ;
  • Yun, So Hui (Department of Anesthesiology and Pain Medicine, Jeju National University Hospital) ;
  • Cho, Seung Yeon (Department of Anesthesiology and Pain Medicine, Jeju National University Hospital) ;
  • Song, Seung Eun (Department of Anesthesiology and Pain Medicine, Jeju National University Hospital) ;
  • Kim, Sang Rim (Department of Orthopedic Surgery, Jeju National University Hospital)
  • 최윤숙 (제주대학교병원 마취통증의학과) ;
  • 윤소희 (제주대학교병원 마취통증의학과) ;
  • 조승연 (제주대학교병원 마취통증의학과) ;
  • 송승은 (제주대학교병원 마취통증의학과) ;
  • 김상림 (제주대학교병원 정형외과)
  • Received : 2021.01.15
  • Accepted : 2021.02.19
  • Published : 2021.04.30
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Abstract

In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

Keywords

References

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