Comparative Study Between Systemic Balanced Analgesia, Continuous Femoral Perineural Analgesia and Continuous Intra-articular Analgesia for Primary Reconstruction Surgery of the Anterior Cruciate Ligament of the Knee

Introduction. The aim of this prospective study was to compare the analgesic efficacy three techniques for knee ligamentoplasty and quadricipital deficit with a view early physiotherapy. Hypothesis. Continuous intra-articular analgesia well-managed systemic could replace continuous femoral peri-nerve in resource-limited countries. Material. - We included 165 patients undergoing primary reconstruction anterior cruciate ligament knee. All underwent spinal anaesthesia. first group, (SA), received balanced postoperatively minimum five days, based on Paracetamol, Diclofenac morphine PCA. In addition already described, second (FA), will benefit from peri-nervous catheter crural position. 20 ml bupivacaine at 0.125% concentration is injected; maintenance set up immediately flow 8 ml/h 36 h. third (IAA) group received, same analgesia, an infusion through epidural bupivacaine, followed by local anesthetic via electric syringe pump Cumulative consumption, pain estimation rest mobilization using numerical scale (EN) 1 10, quadriceps were evaluated. Results. Morphine consumption lower AF difference statistically significant F = 3.539(2) p 0.031. A mean 6.12 ± 2.41 between AS groups 0.012, 1.67 non-significant 0.49 AIA 4.45 2.31 0.056 limit significance groups. Analgesia more effective, reduction EN compared other two Efficacy H4, then H24 H36 but not analgésia. Intra-articular only significantly effective H36. Quadriceps muscle incident specific blocks. Discussion. This suggests that or even well-conducted provides satisfactory ligamentoplasty, peri-nerve. lock absent treatment be advantage speeding functional recovery.