Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement

Authors

Essam Ali Mustafa, Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Al-Azhar University
Mohamed Ahmed Elbadawy Mohamed, Lecturer of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Al-Azhar University
Abdullah Mohamed Shafeek, MB.B.CHFollow

Document Type

Original Article

Abstract

Background: Due to the rising prevalence of knee arthritis at younger ages, total knee replacement (TKR) is one of the most common elective orthopaedic surgeries worldwide. Many of the individuals having this procedure are obese.

The purpose of this study was to assess the effects of sciatic nerve block with combination three-in-one block and hemi spinal anesthesia during total knee replacement surgery.

Patients and methods: Two groups: Group S (hemi spinal anesthesia) and Group B of I, II, and III ASA patients having elective total knee replacement surgery were included in this observational study (combined three in one block and sciatic nerve).

Results: VAS was considerably lower in group B compared to group S at 2, 4, 8, 12, and 24 hours compared to group S at PACU and 1 hour (P value 0.05). When compared to group S, group B considerably delayed the need for the first rescue analgesic (P value 0.001). When compared to group S, group B significantly consumed less morphine overall (P 0.001). The difference between group B and group S in terms of patient satisfaction was statistically significant (P = 0.002).

Conclusion: The combined three-in-one block and sciatic nerve block significantly improve the duration of analgesia in obese patients having total knee replacement surgery, hemodynamic changes, postoperative pain scores, patient satisfaction, and ambulation, and adverse event rates. This allows analgesia providers to optimise their analgesic regimens for these patients.

Keywords

Hemi spinal; nerve block; knee replacement.

How to Cite This Article

Mustafa, Essam Ali; Mohamed, Mohamed Ahmed Elbadawy; and Shafeek, Abdullah Mohamed (2023) "Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement," Al-Azhar International Medical Journal: Vol. 4: Iss. 9, Article 5.
DOI: https://doi.org/10.58675/2682-339X.2020