ملخص الدراسة

82 patients were assessed for eligibility, of whom 66 patients scheduled for primary unilateral total knee arthroplasty (TKA) were randomized to receive either femoral nerve block (FNB) or L3 paravertebral block combined with retro-psoas compartment block (L3 PVB-RPCB). Two patients were lost to follow-up, resulting in 64 patients included in the final analysis (32 per group). All patients received standardized general anesthesia and postoperative patient-controlled analgesia with intravenous sufentanil. The primary outcome of interest was total sufentanil consumption in the first 24 hours postoperatively. Secondary outcomes included pain intensity at rest and during movement, sensory dermatomal coverage at 20 minutes, need for rescue analgesia, patient satisfaction, and the incidence of nausea, vomiting, pruritus, and posterior knee pain. Outcomes were assessed over the first 24 postoperative hours. Overall, the results of the study revealed that L3 PVB-RPCB significantly reduced postoperative opioid consumption and improved early pain control compared with femoral nerve block alone, without increasing opioid-related adverse effects.