Intraoperative landmark-based genicular nerve block versus periarticular infiltration for postoperative analgesia in total knee arthroplasty: a randomized non-inferiority trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(23):5 Reg Anesth Pain Med. 2024 01-Sep;():. 10.1136/rapm-2023-104563What this means for my practice?
GNB provides comparable static pain relief to PAI after total knee arthroplasty but is less effective for dynamic pain and requires more postoperative opioid use. While GNB offers simplicity and reduced injection points, PAI remains preferable in multimodal regimens for optimizing pain management and reducing opioid requirements. However, the study's limitations, including the anesthetic dose discrepancy, suggest further research is needed to refine these techniques.
Study Summary
One hundred forty patients undergoing total knee arthroplasty were randomized to receive either intraoperative landmark-based genicular nerve block (n=69) or periarticular infiltration (n=70). The primary outcome was pain scores at rest and during movement at 12 hours postoperatively using an 11-point Numerical Rating Scale. Secondary outcomes included morphine consumption, time to rescue analgesia, functional performance, and muscle strength. Outcomes were assessed up to 48 hours postoperatively. Overall, the study found that GNB provided non-inferior pain relief at rest but not during movement. Morphine consumption was higher, and time to rescue analgesia was shorter in the GNB group. These findings suggest that while both techniques are effective, PAI may offer slight advantages in dynamic pain management and opioid consumption.
Unlock the Full ACE Report
You have access to 4 more FREE articles this month.
Click below to unlock and view this ACE Reports
Unlock Now
Critical appraisals of the latest, high-impact randomized controlled trials and systematic reviews in orthopaedics
Access to OrthoEvidence podcast content, including collaborations with the Journal of Bone and Joint Surgery, interviews with internationally recognized surgeons, and roundtable discussions on orthopaedic news and topics
Subscription to The Pulse, a twice-weekly evidence-based newsletter designed to help you make better clinical decisions
Exclusive access to original content articles, including in-house systematic reviews, and articles on health research methods and hot orthopaedic topics
Or upgrade today and gain access to all OrthoEvidencecontent for as little as $1.99 per week.
Already have an account? Log in
Are you affiliated with one of our partner associations?
Click here to gain complimentary access as part your association member benefits!
0 of 4 monthly FREE articles unlocked
