A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial
Femoral nerve blocks (FNBs) are used as safe and useful procedures to control severe postoperative pain from total knee arthroplasty (TKA). Various adjuvants have been used to prolong the duration of the local anesthetic blockade. This study evaluated whether a low dose of naloxone administered with...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2021/6639009 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560166990512128 |
|---|---|
| author | Seung Cheol Lee Jeong Ho Kim So Ron Choi Sang Yoong Park |
| author_facet | Seung Cheol Lee Jeong Ho Kim So Ron Choi Sang Yoong Park |
| author_sort | Seung Cheol Lee |
| collection | DOAJ |
| description | Femoral nerve blocks (FNBs) are used as safe and useful procedures to control severe postoperative pain from total knee arthroplasty (TKA). Various adjuvants have been used to prolong the duration of the local anesthetic blockade. This study evaluated whether a low dose of naloxone administered with local anesthetics prolongs the duration of FNB. A prospective, randomized double-blind controlled study was conducted with 74 patients undergoing unilateral TKA. Through a single-bolus administration guided by ultrasound, the control group (group C) received 20 mL of 0.375% ropivacaine, while the naloxone group (group N) received 20 mL of 0.375% ropivacaine with 100 ng of naloxone. The time elapsed before the first analgesia request, the total amount of opioids consumed at 24 h postoperatively, the onset time of the sensory blockade, the visual analog pain scale (VAS) scores after arriving at the recovery room, after 6, 12, 18, and 24 h at rest and after 12, 18, and 24 h of activity, the quadricep strength before the FNB procedure and at 12 and 24 h postoperatively, the quality of sleep on the first night after surgery, the satisfaction score, and the incidence of postoperative complications were recorded. The time elapsed before the first analgesia request was significantly longer in group N (735.5 ± 187.2 min) than that in group C (602.6 ± 210.4 min) (P=0.003). The total dose of supplementary opioids consumed at 24 h postoperatively was significantly lower in group N (312.4 ± 141.7 μg) than that in group C (456.5 ± 279.5 μg) (P=0.007). Lower VAS scores were recorded in group N than that in group C at rest and during knee activity (rest, 12 h, P=0.001, 18 h, P=0.043; activity, 12 h, P=0.001). The addition of a low dose of naloxone to ropivacaine for FNB significantly delayed the first request for rescue analgesia and decreased the opioid consumption within 24 h, without significant complications. |
| format | Article |
| id | doaj-art-26b8dec828f445bca2cd9fba84834fec |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-26b8dec828f445bca2cd9fba84834fec2025-02-03T01:28:18ZengWileyPain Research and Management1203-67651918-15232021-01-01202110.1155/2021/66390096639009A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical TrialSeung Cheol Lee0Jeong Ho Kim1So Ron Choi2Sang Yoong Park3Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan 49201, Republic of KoreaFemoral nerve blocks (FNBs) are used as safe and useful procedures to control severe postoperative pain from total knee arthroplasty (TKA). Various adjuvants have been used to prolong the duration of the local anesthetic blockade. This study evaluated whether a low dose of naloxone administered with local anesthetics prolongs the duration of FNB. A prospective, randomized double-blind controlled study was conducted with 74 patients undergoing unilateral TKA. Through a single-bolus administration guided by ultrasound, the control group (group C) received 20 mL of 0.375% ropivacaine, while the naloxone group (group N) received 20 mL of 0.375% ropivacaine with 100 ng of naloxone. The time elapsed before the first analgesia request, the total amount of opioids consumed at 24 h postoperatively, the onset time of the sensory blockade, the visual analog pain scale (VAS) scores after arriving at the recovery room, after 6, 12, 18, and 24 h at rest and after 12, 18, and 24 h of activity, the quadricep strength before the FNB procedure and at 12 and 24 h postoperatively, the quality of sleep on the first night after surgery, the satisfaction score, and the incidence of postoperative complications were recorded. The time elapsed before the first analgesia request was significantly longer in group N (735.5 ± 187.2 min) than that in group C (602.6 ± 210.4 min) (P=0.003). The total dose of supplementary opioids consumed at 24 h postoperatively was significantly lower in group N (312.4 ± 141.7 μg) than that in group C (456.5 ± 279.5 μg) (P=0.007). Lower VAS scores were recorded in group N than that in group C at rest and during knee activity (rest, 12 h, P=0.001, 18 h, P=0.043; activity, 12 h, P=0.001). The addition of a low dose of naloxone to ropivacaine for FNB significantly delayed the first request for rescue analgesia and decreased the opioid consumption within 24 h, without significant complications.http://dx.doi.org/10.1155/2021/6639009 |
| spellingShingle | Seung Cheol Lee Jeong Ho Kim So Ron Choi Sang Yoong Park A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial Pain Research and Management |
| title | A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial |
| title_full | A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial |
| title_fullStr | A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial |
| title_full_unstemmed | A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial |
| title_short | A Low Dose of Naloxone Added to Ropivacaine Prolongs Femoral Nerve Blockade: A Randomized Clinical Trial |
| title_sort | low dose of naloxone added to ropivacaine prolongs femoral nerve blockade a randomized clinical trial |
| url | http://dx.doi.org/10.1155/2021/6639009 |
| work_keys_str_mv | AT seungcheollee alowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT jeonghokim alowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT soronchoi alowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT sangyoongpark alowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT seungcheollee lowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT jeonghokim lowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT soronchoi lowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial AT sangyoongpark lowdoseofnaloxoneaddedtoropivacaineprolongsfemoralnerveblockadearandomizedclinicaltrial |