Abstract
Objectives
Our randomized clinical study aims to assess genicular nerve block performed intraoperatively compared to a control group without regional block, concerning pain and functional parameters.
Methods
The randomized clinical trial involved 28 patients with primary gonarthrosis scheduled for total knee arthroplasty due to disease progression and failure of conservative treatment.Patients were randomly assigned to two groups: control (Group C) and the proposed intervention (Group I).At the end of the surgical procedure, Group I received levobupivacaine infusion, while Group C received saline solution, targeting the medial-superior, lateral-superior, and medial-inferior genicular nerves.Parameters such as pain, muscle strength, joint effusion, orthostatic capacity, and ambulation were evaluated before and after surgery. Patients also recorded daily pain levels for five days post-procedure, as well as tramadol consumption.Statistical analysis was performed to compare the effects between the groups, adopting a p-value < 0.05 as the significance level.
Results
For the characterization of the cohort based on age and BMI variables, tests indicate no evidence that the studied groups have different profiles.In comparing variables such as Visual Analogue Scale, Muscle Strength, Joint Effusion, and Ambulation/Orthostasis between preoperative and postoperative day 1 evaluations, only one characteristic shows a significant difference. In the Muscle Strength variable, Group I exhibits a greater reduction (p=0.016).Throughout the study's follow-up period, none of the patients experienced any complications related to the surgical procedure.
Conclusion
The genicular nerve block performed intraoperatively during total knee arthroplasty surgeries, when done in isolation, proved ineffective in reducing postoperative pain and did not result in any benefit for early return to ambulation.The authors believe that further studies on the matter are necessary, with a larger number of patients, in order to better describe the outcomes of the intervention.