Combined continuous "3-in-1" and sciatic nerve blocks provide improved postoperative analgesia with no correlation to catheter tip location after unilateral total knee arthroplasty.

Abstract

This study assessed the efficacy and duration of postoperative analgesia after continuous sciatic nerve block with and without continuous "3-in-1" block with bupivacaine after unilateral total knee arthroplasty and determined catheter tip correlation with analgesia. Thirty patients were randomized into 2 groups. Results suggested significantly reduced pain and rescue analgesic requirement in combined sciatic and 3-in-1 (group TS) compared to 3-in-1 group alone (group T). The postoperative pain-free interval and satisfaction score was significantly higher in the combined group (P < .05). The percentage of catheters in the ideal position was 53.3% for 3-in-1 and 93.3% for sciatic nerve. In conclusion, continuous sciatic nerve block when added to continuous 3-in-1 block provides a better quality of analgesia with lesser requirements of rescue analgesics without the need for routine radiographic conformation.