Elective unilateral total knee replacement using continuous femoral nerve blockade versus conventional patient-controlled analgesia: perioperative patient management based on a multidisciplinary pathway

60 patients undergoing unilateral elective total knee arthroplasty under spinal anaesthesia were randomized to undergo a newly-proposed multidisciplinary postoperative treatment protocol involving multimodal analgesia and either continuous femoral nerve blockade (CFNB) or conventional patient-controlled analgesia (PCA). The purpose of this study was to compare clinical and functional outcomes associated with these two treatment approaches. Results indicated that the CFNB group displayed significantly lower total morphine consumption on postoperative days 0 and 1, experienced fewer instances of opioid-related side-effects, and had high patient satisfaction regarding pain control. The number of patients who underwent first mobilization on postoperative day 1 was significantly higher in the CFNB group. Pain at rest and during mobilization, patient satisfaction regarding the total knee replacement pathway used in this study, hospital stay, the incidence of complications and Knee Society Scores up to 6 months were similar between groups.