Abstract:
BACKGROUND:Total knee arthroplasty (TKA) is the most common treatment for end-stage knee osteoarthritis and continuous femoral nerve block (CFNB) has become the gold standard for analgesia. But the lack of knowledge about CFNB and patient-controlled analgesia (PCA) often leads to inappropriate dose of medications and increased workload for ward nurses. METHODS:After retrospectively registering to http://www.chictr.org.cn (ChiCTR1800018957), 60 patients undergoing unilateral TKA were randomly divided into groups A and B (n = 30 each). Patients in group B and their families received a nurse-led preoperative visit the day before surgery focusing on PCA educational pamphlets for postoperative pain management. Before returning to the ward, patients and their families in both groups received face-to-face PCA pump operation training. The usual postoperative follow-up was performed by nurse anesthetists for 2 consecutive days. Visual Analogue Scale (VAS) scores at rest and during movement, knowledge of the PCA evaluated by a ten-question questionnaire, knee flexion angles, and the number of PCA-related nurse calls were recorded. RESULTS:The VAS scores at rest and during movement of the patients in group B were both significantly lower than in group A on postoperative days 1 and 2. The questionnaire scores of the patients in group B were much higher than those in group A on postoperative day 1, but not on day 2. Patients in the 2 groups had similar knee flexion on postoperative days 1 and 2. Patients in group B asked for assistance from the ward nurses with the PCA fewer times than those in group A, and the ward nurses were more satisfied with the analgesic protocol in group B. CONCLUSIONS:Enhanced preoperative education for CFNB with PCA can provide patients with a better grasp of postoperative pain management, improve the postoperative analgesic effect after TKA, and reduce the PCA-related workload for ward nurses. TRIAL REGISTRATION:This study was retrospectively registered to ChiCTR (identifier: ChiCTR1800018957 ) on October 18, 2018.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Lin X,Zhou Y,Zheng H,Zhang J,Wang X,Liu K,Wang J,Guo X,Li Z,Han Bdoi
10.1186/s12871-019-0826-3subject
Has Abstractpub_date
2019-08-14 00:00:00pages
150issue
1issn
1471-2253pii
10.1186/s12871-019-0826-3journal_volume
19pub_type
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