Preoperative peripheral nerve blockade in the perioperative pain management and early mobilization of patients after anterior cruciate ligament reconstruction

Abstract

Rekonstrukcija prednje ukrižene sveze koljenskog zgloba jedna je od najčešćih operacija u ortopedskoj kirurgiji. Artroskopski zahvat umanjuje kiruršku traumu, ali poslijeoperacijska bol ostaje i dalje klinički problem u prva 24 sata produžavajući oporavak bolesnika. Dosadašnji standard kontrole poslijeoperacijske boli uključivao je visoke doze parenteralno primijenjenih centralnih analgetika praćene čestim mučninama i povraćanjem i dužim poslijeoperacijskim oporavkom. Cilj ovog rada je istražiti uspješnost poslijeoperacijske analgezije prijeoperacijskom blokadom ciljanih perifernih živaca pod kontrolom ultrazvuka koristeći malu dozu lokalnog anestetika. Slučajno odabranih 150 bolesnika imat će uniformnu anesteziju, a bit ce podijeljeni u tri skupine prema metodi analgezije: intravenska i dva modaliteta regionalne. Očekuje se da će se dokazati razlika u uspješnosti tri vrste analgezije, te njihov utjecaj na brzinu poslijeoperacijskog oporavka.Anterior cruciate ligament (ACL) reconstruction is one of the most frequent arthroscopic procedures done in orthopaedic surgery, and also one of the most painful. Although arthroscopy is associated with less tissue trauma, pain during the first 24-postoperative hours is still a clinical concern. Standardized methods with central analgesics in continuous parenteral infusion were associated with nausea, vomiting and longer hospital stay. The aim of this study is to investigate the success rate of preoperative ultrasound-guided peripheral nerve blockade using low dose of local anesthetic. For this purpose, 150 patients scheduled for the ACL reconstruction will be included in this study. They will be uniformly anesthetized and randomized between three groups: intravenous and two models of regional analgesia. It is expected to find the difference in success rate between the three analgesia techniques and their influence on postoperative recovery and early mobilization