• Fu-Yuen Ng, Kwong-Yuen Chiu, Chun Hoi Yan, and Kwok-Fu Jacobus Ng.
• Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong. charlesnfy@gmail.com
• J Orthop Surg (Hong Kong). 2012 Apr 1;20(1):23-6.

PurposeTo compare total knee arthroplasty (TKA) patients who received continuous femoral nerve block (FNB) with local anaesthetics through a catheter versus patient-controlled analgesia (PCA) with intravenous morphine.Methods50 women and 10 men aged 51 to 84 years with matched characteristics underwent TKA and received either continuous FNB with local anaesthetics through a catheter (n=30) or PCA with intravenous morphine (n=30). None of the patients had had previous knee surgery. All operations were performed according to the standard protocol. Daily mean pain numerical rating scale at rest (NRS-R) and during movement (NRS-M), requirement of extra pain control, complications related to pain control, and overall patient satisfaction in both groups were compared.ResultsBoth groups were similar in terms of pain NRS-R and NRS-M, overall satisfaction, and length of hospital stay. Within each group, pain NRS-M score was significantly higher than pain NRS-R score. In the FNB group, 3 patients had dislodgement of the femoral catheter on day 1 and switched to PCA with intravenous morphine. Two of them had fair satisfaction. Patients in the PCA group had significantly more side-effects (nausea, vomiting, dizziness, and pruritis); 2 of the 5 patients with nausea and vomiting had fair satisfaction. No patients had any surgical complication.ConclusionBoth FNC and PCA provide reliable pain control.

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