PMID- 29203380
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20190128
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 34
IP  - 1
DP  - 2018 Jan
TI  - Periarticular Injection Versus Femoral Nerve Block for Pain Relief After Anterior 
      Cruciate Ligament Reconstruction: A Randomized Controlled Trial.
PG  - 182-188
LID - S0749-8063(17)31173-8 [pii]
LID - 10.1016/j.arthro.2017.08.307 [doi]
AB  - PURPOSE: To compare the effectiveness and safety of periarticular injection (PI) 
      with those of femoral nerve block (FNB) after anterior cruciate ligament (ACL) 
      reconstruction. METHODS: A total of 129 patients scheduled for ACL reconstruction 
      were randomly assigned to receive PI or FNB. Other perioperative interventions 
      were identical for all patients. The primary outcome was the postoperative pain 
      score 24 hours after surgery, which was measured using a 100-mm visual analog 
      scale (VAS). The pain scores were also assessed to determine whether the VAS 
      score would reach the threshold values reported for the minimal clinically 
      important difference (MCID) and patient acceptable symptomatic state (PASS). 
      RESULTS: The PI group had significantly lower VAS scores 24 hours after ACL 
      reconstruction than the FNB group (21 mm vs 39 mm; P < .0001). Consequently, the 
      primary outcome reached the level of clinical significance as indicated by the 
      threshold values of an MCID of 9.9 and a PASS of 33. The PI group also had a 
      significantly lower VAS score at rest at 4 hours, 8 hours, and 2 days after 
      surgery (30 mm vs 39 mm [P = .025], 25 mm vs 33 mm [P = .022], and 22 mm vs 32 mm 
      [P = .0022], respectively). The opioid consumption during the initial 24 hours 
      was significantly lower in the PI group (354 mug vs 503 mug; P = .0003). The 
      complication rate, including opioid-related complications, was not significantly 
      different between groups. CONCLUSION: The patients treated with PI had 
      significantly better pain scores and lower opioid consumption than those treated 
      with FNB without elevating the complication rate. LEVEL OF EVIDENCE: Level I, 
      randomized controlled trial.
CI  - Copyright (c) 2017 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Kurosaka, Kenji
AU  - Kurosaka K
AD  - Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya City, 
      Hyogo, Japan. Electronic address: kenjikurosaka@yahoo.co.jp.
FAU - Tsukada, Sachiyuki
AU  - Tsukada S
AD  - Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, Mito City, Ibaraki, 
      Japan.
FAU - Nakayama, Hiroshi
AU  - Nakayama H
AD  - Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya City, 
      Hyogo, Japan.
FAU - Iseki, Tomoya
AU  - Iseki T
AD  - Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya City, 
      Hyogo, Japan.
FAU - Kanto, Ryo
AU  - Kanto R
AD  - Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya City, 
      Hyogo, Japan.
FAU - Sugama, Ryo
AU  - Sugama R
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka City, Osaka, Japan.
FAU - Yoshiya, Shinichi
AU  - Yoshiya S
AD  - Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya City, 
      Hyogo, Japan.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20171206
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics, Local)
RN  - 0 (Anti-Inflammatory Agents)
RN  - 7IO5LYA57N (Ropivacaine)
RN  - 90Y4QC304K (Ketoprofen)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Analgesics, Opioid/administration & dosage
MH  - Anesthetics, Local/administration & dosage
MH  - Anterior Cruciate Ligament Reconstruction/*adverse effects
MH  - Anti-Inflammatory Agents/administration & dosage
MH  - Female
MH  - Femoral Nerve/*drug effects
MH  - Humans
MH  - Injections, Intra-Articular/methods
MH  - Japan
MH  - Ketoprofen/administration & dosage
MH  - Male
MH  - Methylprednisolone/administration & dosage
MH  - Nerve Block/adverse effects/*methods
MH  - Pain Management/adverse effects/*methods
MH  - Pain Measurement/drug effects/methods
MH  - Pain, Postoperative/*therapy
MH  - Prospective Studies
MH  - Ropivacaine/administration & dosage
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2017/12/06 06:00
MHDA- 2019/01/29 06:00
CRDT- 2017/12/06 06:00
PHST- 2017/04/21 00:00 [received]
PHST- 2017/08/19 00:00 [revised]
PHST- 2017/08/19 00:00 [accepted]
PHST- 2017/12/06 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2017/12/06 06:00 [entrez]
AID - S0749-8063(17)31173-8 [pii]
AID - 10.1016/j.arthro.2017.08.307 [doi]
PST - ppublish
SO  - Arthroscopy. 2018 Jan;34(1):182-188. doi: 10.1016/j.arthro.2017.08.307. Epub 2017 
      Dec 6.