AUTHOR=Sreckovic Svetlana , Ladjevic Nebojsa , Milicic Biljana , Tulic Goran , Milovanovic Darko , Djukanovic Marija , Kadija Marko 

TITLE=Chronic post-surgical pain after knee arthroplasty: a role of peripheral nerve blocks

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1335405

DOI=10.3389/fmed.2023.1335405

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Introduction</title><p>Peripheral nerve blocks are an efficient method of pain control after total knee arthroplasty (TKA), but there is no report of their impact on chronic post-surgical pain (CPSP).</p></sec><sec id="sec2"><title>Methods</title><p>This prospective observational study aimed to assess adductor canal block (ACB) and IPACK block (blocks vs. no blocks) on opioid consumption, postoperative pain score, chronic post-surgical pain 2 years after TKA.</p></sec><sec id="sec3"><title>Results</title><p>166 patients (82 vs. 84) were analyzed. Opioid consumption was less in the group with blocks (9.74 ± 3.87 mg vs. 30.63 ± 11.52 mg) (<italic>p</italic> &lt; 0.001). CPSP was present in 20.24% of patients in the group without blocks and 6.1% of patients with blocks (<italic>p</italic> = 0.011). Predictor variables of CPSP included pain before surgery (cut-off of 5.5), pain at rest (cut-off of 2.35), pain during active movement (cut-off: 2.5), and opioid consumption (cut-off: 8 mg).</p></sec><sec id="sec4"><title>Conclusion</title><p>Peripheral nerve blocks provide adequate analgesia, significantly decrease opioid consumption, improve functional outcomes, and reduce CPSP 2 years after surgery.</p></sec>