Femoral nerve block and ketorolac in patients undergoing anterior cruelate ligament reconstruction

Abstract

Purpose: The primary objective was to evaluate the analgesic effectiveness of femoral nerve block and ketorolac following ACL reconstruction. The secondary objective was to examine their effects on recovery milestones. Methods: Prior to standard general anesthesia, 90 patients were randomized into three groups of preoperative treatment: 1) femoral nerve block (15 mL bupivacaine 0.5%) and 1 mL normal saline iv (FNB group); 2) placebo femoral nerve block (15 mL normal saline) and 30 mg (1 mL) ketorolac iv (KT group); 3) placebo femoral nerve block (15 mL normal saline) and 1 mL normal saline iv (PL group). Postoperatively, pain was assessed by visual analogue score, demand and consumption of morphine via patient- controlled analgesia pump. The times for patients to tolerate oral fluid, food, sit up, ambulate and void were also noted. Results: Morphine consumption within one hour, three hours and until POD 1 in the FNB group was lower than the PL group (7 ± 6, 11 ± 9, 27 ± 23 mg vs 13 ± 5, 20 ± 9, 49 ± 28 mg respectively), whereas only that within one hour in the KT group was lower than the PL group. Pain score was lower in FNB and KT groups in the first postoperative hour than in the PL group (P < 0.05). There were no differences among the three groups in the times to meet recovery milestone and discharge criteria. Conclusion: Femoral nerve block provides superior analgesia than placebo for ACL reconstruction but was insufficient to facilitate early recovery.