الفهرس 
Anatomy of the Knee JointOnly 14 pages are availabe for public view
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Abstract
T
otal knee arthroplasty (TKA) is a highly agonizing surgery with a considerable possibility for complications, not only related to the surgical impact of the procedure, but also related to demographic and clinical characteristics of the target patients. Ideal postoperative pain control methods following surgery are directed to provide adequate pain relief with least opioid consumption and to preserve the motor strength to hinder postoperative complications. The implementation of multimodal methods including regional anaesthesia are broadly used to encounter such expectations.
Several different analgesic modalities, including continuous epidural analgesia, femoral nerve block, continuous opioid infusion, local infiltration analgesia (LIA), and saphenous nerve block in the adductor canal, are described for managing postoperative pain following total knee arthroplasty.
This study was conducted over 60 patients older than 40 years old, who had unilateral TKA under spinal anesthesia. They were divided to three groups. group A (epidural group) who received continuous epidural analgesia, group B (femoral group) who received continuous femoral nerve block (CFNB) and group C (adductor group) who received continuous adductor canal block (ACB).
The comparison is between the effectiveness of postoperative analgesics and the amount of morphine taken after surgery. Postoperative analgesic efficacy was assessed at 0, 1, 6, 12, 24, 36, and 48 hours using VAS scores. Additionally, hemodynamic changes (mean blood pressure and heart rate) and side effects such as pruritis, nausea, vomiting and requirement of analgesic doses for the first 48 hours after the surgery were noted.
In our study, we found that continuous epidural analgesia provides superior analgesia after total knee replacement than continuous femoral nerve block and continuous adductor canal block, with relatively more side effects such as dizziness, pruritus, PONV and duration of hospital stay.