Health-related quality of life after tricompartment knee arthroplasty with and without an extended-duration continuous femoral nerve block

A prospective, 1-year follow-up of a randomized, triple-masked, placebo-controlled study

Brian M. Ilfeld, R. Scott Meyer, Linda T. Le, Edward R. Mariano, Brian A. Williams, Krista Vandenborne, Pamela W. Duncan, Daniel I. Sessler, F. Kayser Enneking, Jonathan J. Shuster, Rosalita C. Maldonado, Peter F. Gearen

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

BACKGROUND:: We previously provided evidence that extending an overnight continuous femoral nerve block to 4 days after tricompartment knee arthroplasty (TKA) provides clear benefits during the perineural infusion in the immediate postoperative period. However, it remains unknown if the extended infusion improves subsequent health-related quality of life between 7 days and 12 mo. METHODS:: Patients undergoing TKA received a femoral perineural infusion of ropivacaine 0.2% from surgery until the following morning, at which time patients were randomized to either continue perineural ropivacaine (n = 25) or normal saline (n = 25) in a double-masked fashion. Patients were discharged with their catheter and a portable infusion pump, and catheters were removed on postoperative day 4. Health-related quality of life was measured using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index preoperatively and then at 7 days, as well as 1, 2, 3, 6, and 12 mo after surgery. The WOMAC evaluates three dimensions of health-related quality of life: pain, stiffness, and physical functional disability. For inclusion in the analysis, we required a minimum of 4 of the 6 time points, including day 7 and at least 2 of mo 3, 6, and 12. RESULTS:: The two treatment groups had similar WOMAC scores for the mean area under the curve calculations (point estimate for the difference in mean area under the curve for the two groups [overnight infusion group-extended infusion group] = 1.2, 95% confidence interval: -5.6 to +8.0; P = 0.72) and at all individual time points (P > 0.05). CONCLUSIONS:: We found no evidence that extending an overnight continuous femoral nerve block to 4 days improves (or worsens) subsequent health-related quality of life between 7 days and 12 mo after TKA. (ClinicalTrials.gov number, NCT00135889.)

Original languageEnglish
Pages (from-to)1320-1325
Number of pages6
JournalAnesthesia and Analgesia
Volume108
Issue number4
DOIs
Publication statusPublished - Apr 2009
Externally publishedYes

    Fingerprint

Cite this