Peripheral nerve block as the component of anesthesia and postoperative analgesia for total knee arthroplasty

Background: Regional anesthesia is most often used for orthopedic surgery. Nowadays peripheral nerve blocks are the most widespread techniques for anesthesia as well as for postoperative pain relief. Purpose: To evaluate the possibility of different peripheral nerve blocks as the component of anesthesia and postoperative analgesia in total knee arthroplasty. Methods: Retrospective analysis of 66 cases of total knee replacement under general anesthesia or in combination with peripheral nerve block. Total intravenous anesthesia with propofol, ketamine and fentanyl was performed for all patients. Patients received either alone general anesthesia (12 patients) or general anesthesia with continuous fascia iliaca compartment block (17 patients) or general anesthesia with continuous femoral nerve block (18 patients) or general anesthesia with single femoral nerve block (19 patients). Results: The total consumption of propofol was less in groups of patients under general anesthesia combined with different peripheral nerve block compared to alone general anesthesia group. Application of continuous peripheral nerve block techniques was associated with a lower consumption of trimeperidine for postoperative analgesia. Hypertension was observed only in the general anesthesia group, while hypotension was detected in the patients who received the peripheral nerve block (42% and 9% respectively). Conclusion: Peripheral nerve block is an effective and safe component of anesthesia for total knee arthroplasty. Continuous peripheral nerve blocks are more effective than a single block alone for postoperative pain relief.