Is Femoral Nerve Block Necessary During Total Knee Arthroplasty?

There remains a lack of randomized controlled trials comparing methods of perioperative analgesia for total knee arthroplasty. To address this deficiency, a blinded, randomized controlled trial was conducted to compare the use of femoral nerve block (group F) and local anesthetic (group L). A sample of 55 patients who met the inclusion criteria were randomized to either group. No significant differences in the most severe pain score or 36-Item Short Form Health Survey, The Western Ontario and McMaster Universities Arthritis Index (WOMAC), or Oxford scores were observed between groups. However, the Knee Society score was significantly higher in group F. In addition, group F used significantly fewer micrograms of intravenous fentanyl in the first 24 hours. Balancing the risks of femoral nerve block with those of increased systemic narcotic delivery should be performed on a case-by-case basis.