Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement
Mustafa, E., Mohamed, M., Shafeek, A. (2644). Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement. EKB Journal Management System, 2023(1), -. doi: 10.58675/2682-339X.2020
Essam Ali Mustafa; Mohamed Ahmed Elbadawy Mohamed; Abdullah Mohamed Shafeek. "Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement". EKB Journal Management System, 2023, 1, 2644, -. doi: 10.58675/2682-339X.2020
Mustafa, E., Mohamed, M., Shafeek, A. (2644). 'Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement', EKB Journal Management System, 2023(1), pp. -. doi: 10.58675/2682-339X.2020
Mustafa, E., Mohamed, M., Shafeek, A. Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement. EKB Journal Management System, 2644; 2023(1): -. doi: 10.58675/2682-339X.2020

Comparative Study Between Hemi spinal Anesthesia with Fentanyl Versus Ultrasound Guided Combined Three in One Block Plus Sciatic Nerve Block in Overweight Patients Undergoing Total Knee Replacement

Al-Azhar International Medical Journal
Volume 2023, Issue 1, January 2023  XML
DOI: 10.58675/2682-339X.2020
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Authors
Essam Ali Mustafa1; Mohamed Ahmed Elbadawy Mohamed2; Abdullah Mohamed Shafeek3
1Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Al-Azhar University
2Lecturer of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Al-Azhar University
3MB.B.CH
Abstract
Background: Due to the rising prevalence of knee arthritis at younger ages, total knee replacement (TKR) is one of the most common elective orthopaedic surgeries worldwide. Many of the individuals having this procedure are obese. The purpose of this study was to assess the effects of sciatic nerve block with combination three-in-one block and hemi spinal anesthesia during total knee replacement surgery.  Patients and methods: Two groups: Group S (hemi spinal anesthesia) and Group B of I, II, and III ASA patients having elective total knee replacement surgery were included in this observational study (combined three in one block and sciatic nerve). Results: VAS was considerably lower in group B compared to group S at 2, 4, 8, 12, and 24 hours compared to group S at PACU and 1 hour (P value 0.05). When compared to group S, group B considerably delayed the need for the first rescue analgesic (P value 0.001). When compared to group S, group B significantly consumed less morphine overall (P 0.001). The difference between group B and group S in terms of patient satisfaction was statistically significant (P = 0.002). Conclusion: The combined three-in-one block and sciatic nerve block significantly improve the duration of analgesia in obese patients having total knee replacement surgery, hemodynamic changes, postoperative pain scores, patient satisfaction, and ambulation, and adverse event rates. This allows analgesia providers to optimise their analgesic regimens for these patients.
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