Abstract
Total knee arthroplasty (TKA) is a common but painful orthopaedic surgical procedure. Adequate perioperative analgesia is very important for promoting the recovery of motor functions and postoperative rehabilitation. Formerly, neuraxial analgesia, such as epidural or subarachnoidal analgesia, has been used to provide appropriate perioperative analgesia. However, with the need to provide perioperative anticoagulant therapy after TKA, the use of peripheral nerve blocks has replaced neuraxial analgesia. The development of ultrasound technology has also led to the popularization of ultrasound guidance when performing peripheral nerve blocks. Peripheral nerve blocks provide much better postoperative analgesia and range of motion. Especially, the combination of a continuous femoral nerve block (CFNB) and intravenous opioids is considered to be a standard analgesic procedure for knee surgery. However, CFNB also leads to weakness of the quadriceps muscle. Recently, an adductor canal block and periarticular injection have been reported as alternative forms of analgesia for CFNB by some investigators. It is crucial for anesthesiologists to master the procedures for performing peripheral nerve blocks and to recognize which combination of analgesic methods is best for each patient.
