Runge C, et al. - Researchers assessed the analgesic effect of combined obturator nerve and femoral triangle blockade (OFB) vs local infiltration analgesia (LIA) after total knee arthroplasty (TKA) when all patients received high-dose intravenous dexamethasone. In such a setting where all patients received high-dose intravenous dexamethasone, combined OFB vs LIA offered a better reduction of morphine consumption post-TKA.

Methods

• Either OFB or LIA was received by 82 patients in a random fashion after primary unilateral TKA.
• Dexamethasone 16 mg was administered to all patients.
• Primary outcome was morphine consumption via patient-controlled analgesia during the first 20 postoperative hours.
• Pain, nausea, dizziness, and length of hospital stay were secondary outcomes.

Results

• Overall, 74 patients were included.
• During the first 20 postoperative hours, median total intravenous morphine consumption was noted to be 6 mg (interquartile range [IQR], 2–18 mg) in the OFB group and 20 mg (IQR, 12–28 mg) in the LIA group.
• Significant (P < 0.001) 14-mg difference (95% confidence interval, 6.4–18.0 mg) was noted.
• At 20 hours postoperatively, no difference was observed in pain score at rest: 2 (IQR, 1–4) in the OFB group and 3 (IQR, 2–5) in the LIA group.