무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향

• Published in: Journal of medicine and life science Vol. 18; no. 1; pp. 11 - 15
• Main Authors: 최윤숙, 윤소희, 조승연, 송승은, 김상림, Choi, Yun Suk, Yun, So Hui, Cho, Seung Yeon, Song, Seung Eun, Kim, Sang Rim
• Format: Journal Article
• Language: Korean
• Published: 의과학연구소 01.04.2021
• Subjects: 의학일반; Total knee arthroplasty; Nerve block; Postoperative blood loss; Pain management
• ISSN: 1738-1010; 2671-4922
• DOI: 10.22730/jmls.2021.18.1.11

In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.