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• W4247130505 abstract "Extended “three‐in‐one” block after total knee arthroplasty: continuous versus patient‐controlled techniques. (St. Luc Hospital, Brussels, Belgium) Anesth Analg 2000;91:176–180. This prospective, randomized, doubled‐blinded study assessed the efficacy of patient‐controlled analgesia (PCA) techniques for an extended “3‐in‐1” block after total knee arthroplasty. A total of 45 patients were divided into 3 groups of 15. Over 48 h, all patients received 0.125% bupivacaine with 1 μg/mL clonidine via a femoral nerve sheath catheter in the following manner: as a continuous infusion at 10 mL/h in Group 1; as a continuous infusion at 5 mL/h plus PCA boluses (2.5 mL/30 min) in Group 2; or as PCA boluses only (10 mL/60 min) in Group 3. Pain scores, sensory block, supplemental analgesia, bupivacaine consumption, side effects, and satisfaction scores were recorded. Pain scores and supplemental analgesia were comparable in the three groups. Bupivacaine consumption was significantly less in Groups 2 and 3 than in Group 1 ( P < 0.01), and in Group 3 than in Group 2 ( P < 0.01). Side effects and satisfaction were comparable in the 3 groups. Conclude that extended “3‐in‐1” block provides efficient pain relief after total knee arthroplasty and that, compared with a continuous infusion, PCA techniques reduce the total anesthetic consumption without compromise in patient satisfaction or visual analog scale scores. Of the 2 PCA techniques tested, PCA boluses (10‐mL lockout; time 60 min) of 0.125% bupivacaine with 1 μg/mL clonidine was associated with the smallest local anesthetic consumption, and is, therefore, the recommended extended “3‐in‐1” block technique. Comment by Octavio Calvillo, MD, PhD. In a prospective, randomized, double‐blinded study, the authors studied the efficacy of the 3 in 1 block in a group of patients that had undergone total knee arthroplasty. Patients were allocated to 3 groups; all patients had a catheter implanted in the femoral sheath. Over 48 h all patients received 0.125% bupivacaine with 1 μg/mL clonidine. Group 1 received the mixture as a continuous infusion at 10 mL/h. Group 2 received a continuous infusion at 5 mL/h plus PCA boluses (2.5 mL/30 min). Group 3 received 10 mL of solution per 60 min. Pain scores, supplemental analgesia side effects, and patient satisfaction were comparable in all groups. Bupivacaine consumption was significantly lower in Group 2 and Group 3 as compared to Group 1 ( P < 0.01). Of the PCA techniques studied, the regimen involving 10 mL per h was associated with the lowest local anesthesia consumption and is, therefore, the recommended technique for extended 3 in 1 block." @default.
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• W4247130505 date "2001-01-01" @default.
• W4247130505 modified "2023-10-16" @default.
• W4247130505 title "Anesthesia (7)" @default.
• W4247130505 doi "https://doi.org/10.1111/j.1533-2500.2001.1011-7.x" @default.
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