TY - JOUR
T1 - Health-related quality of life after tricompartment knee arthroplasty with and without an extended-duration continuous femoral nerve block
T2 - A prospective, 1-year follow-up of a randomized, triple-masked, placebo-controlled study
AU - Ilfeld, Brian M.
AU - Meyer, R. Scott
AU - Le, Linda T.
AU - Mariano, Edward R.
AU - Williams, Brian A.
AU - Vandenborne, Krista
AU - Duncan, Pamela W.
AU - Sessler, Daniel I.
AU - Enneking, F. Kayser
AU - Shuster, Jonathan J.
AU - Maldonado, Rosalita C.
AU - Gearen, Peter F.
PY - 2009/4
Y1 - 2009/4
N2 - 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.)
AB - 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.)
UR - http://www.scopus.com/inward/record.url?scp=63849094639&partnerID=8YFLogxK
U2 - 10.1213/ane.0b013e3181964937
DO - 10.1213/ane.0b013e3181964937
M3 - Article
C2 - 19299806
AN - SCOPUS:63849094639
VL - 108
SP - 1320
EP - 1325
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 4
ER -