Does using a femoral nerve block for total knee replacement decrease postoperative delirium?

BMC Anesthesiology

Research Article

Sakura Kinjo¹  Jacqueline M Leung¹  Kevin J Bozic²  Eunjung Lim³  Laura P Sands³ 

[1] Department of Anesthesia and Perioperative Care, University of California, 94143-0648, San Francisco, CA, USA;Department of Orthopaedic Surgery, University of California, 94143-0728, San Francisco, CA, USA;School of Nursing, Purdue University, 47907-2069, West Lafayette, IN, USA;

关键词: Ropivacaine;    Total Knee Replacement;    Patient Control Analgesia;    Hydromorphone;    Postoperative Delirium;   

DOI  :  10.1186/1471-2253-12-4

 received in 2011-08-11, accepted in 2012-03-10,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect.MethodsA prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups.Results85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use.ConclusionsFemoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.

【 授权许可】

CC BY   
© Kinjo et al; licensee BioMed Central Ltd. 2012