Effect of pre-emptive analgesia by continuous femoral nerve block on early postoperative cognitive function following total knee arthroplasty in elderly patients

Deng,Li-Qin; Hou,Lei-Na; Song,Feng-Xiang; Zhu,Han-Yue; Zhao,Hai-Ying; Chen,Gang; Li,Jing-Jing

doi:10.3892/etm.2017.4099

Effect of pre-emptive analgesia by continuous femoral nerve block on early postoperative cognitive function following total knee arthroplasty in elderly patients

Authors:
- Li-Qin Deng
- Lei-Na Hou
- Feng-Xiang Song
- Han-Yue Zhu
- Hai-Ying Zhao
- Gang Chen
- Jing-Jing Li
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Affiliations: Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China, School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
Published online on: February 3, 2017 https://doi.org/10.3892/etm.2017.4099
Pages: 1592-1597

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Abstract

To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30). POCD was defined as a two-point reduction in the postoperative score compared with the preoperative score in the mini-mental state examination. The visual analog scale (VAS) was used to evaluate the intensity of pain at rest and during exercise. The intraoperative dose of remifentanil in the pre-emptive analgesia group was significantly lower than in the control group (P<0.01). In the preemptive analgesia group, VAS scores at three days post‑surgery were lower than those in the control group (P<0.01). The incidence of POCD on the third postoperative day was slightly lower in the pre-emptive analgesia group compared with the control group. In conclusion, the results demonstrate that pre-emptive analgesia by CFNB may promote the recovery of early cognitive function following TKA in elderly patients.

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