Popliteal plexus block in total knee arthroplasty: a single-center randomized controlled double-blinded trial.

Study Summary

66 patients undergoing total knee arthroplasty (TKA) were randomized to receive continuous femoral nerve block (CFNB) + popliteal plexus block (PPB) or CFNB alone. The primary outcome of interest was cumulative 12-hour postoperative morphine-equivalent (ME) opioid consumption. Secondary outcomes included opioid consumption at additional postoperative time points, Visual Analogue Scale (VAS) pain scores, knee pain location, postoperative nausea and vomiting, and sensorimotor extension of the block. Outcomes were assessed in the postanesthesia care unit (PACU) and at 12, 24, and 48 hours postoperatively. Overall, the results of the study revealed that the addition of a PPB significantly reduced 12-hour opioid consumption and decreased early postoperative pain intensity and lateroposterior knee pain. However, these analgesic benefits diminished after 24 hours, and the magnitude of opioid reduction was modest. The findings suggest that PPB may be a useful addition within a multimodal analgesic strategy for TKA, although its clinical relevance remains uncertain.