الفهرس 
Anatomy of Nerves of Lower LimbOnly 14 pages are availabe for public view
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Abstract
Total knee arthroplasty (TKA) is common surgical procedure for treatment of the degenerative disorders and traumatic diseases. However, a majority of patients often experience moderate to severe postoperative pain after TKA. Postoperative pain control has a significant impact on earlier ambulation, initiation of physiotherapy, and better functional recovery. In addition, effective pain control would lower the length of hospital stay and the risk of thrombotic events which improves patients’ satisfaction.
The fascia iliaca compartment and femoral nerve block performed by landmark technique are inexpensive, safe and easy to perform. They deliver effective pain relief whilst avoiding the undesirable side-effects of certain other forms of analgesia.
The aim of this study was to compare the effect of fascia iliaca block versus femoral nerve block on post operative analgesia in patients undergoing TKA.
After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n=35; each); FICB group and FNB group.
• FICB Group: Patients (n=35) of this group received ultrasound guided Fascia iliaca compartment block (FICB) after spinal anesthesia using 15-17 ml of 0.5% bupivacaine.
• FNB Group: Patients (n=35) of this group received ultrasound guided femoral nerve block after spinal anesthesia using 15-17 ml of 0.5% bupivacaine.
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia. Demographic data and post-operative hemodynamics were also assessed.
The present study showed that fascia iliaca block was more efficient than femoral nerve block. The first rescue for analgesia (pethidine), total pethidine consumption and pain scores (VAS) indicated that the superiority of the fascia iliaca block technique over the femoral nerve block technique. The patients of group femoral nerve block had higher pain scores and were the first to ask for rescue analgesia; therefore, they had highest total pethidine consumption in the first 24 hours postoperatively in comparison to patients of group fascia iliaca block.