Nerve block modality selection in total knee arthroplasty: Evaluating single-shot versus continuous catheter on...

IntroductionTotal knee arthroplasty (TKA) requires effective postoperative pain control to promote early mobilization, improve outcomes, and reduce complications. Common strategies include catheter-based analgesia and single-shot nerve blocks, both of which have distinct advantages and limitations. This study aims to compare the outcomes and complications of both techniques in patients who underwent primary TKA.Materials and methodsThis is a retrospective cohort study conducted at a tertiary care hospital. Patients included had undergone primary total knee arthroplasty by a single surgeon and received either a catheter or a single-shot nerve block post TKA as a pain management modality.ResultsThe study included 204 patients who underwent TKA. Females represented the majority of the sample (n = 172, 84.3%), with most patients aged 61 years and older (n = 156, 76.4%). The majority of our sample was obese (n = 164, 81.1%). Catheter analgesia was utilized in 110 cases (53.9%) and single-shot nerve blocks in 94 (46.1%). Catheter analgesia use was significantly associated with lower narcotic use after 3 weeks (9.1% vs 90.9%) with a large effect size (Cramer's V = 0.31, p < 0.001), a better range of motion at discharge (p = 0.013, V = 0.19), and lower pain mean VAS (0.15 vs 3.88), with a very large effect size (Eta Square = 0.68, p < 0.001) compared to a single-shot nerve block.ConclusionsThis study shows that both catheter and single-shot nerve block provided effective postoperative analgesia after TKA. Catheter use was associated with lower VAS scores, less prolonged narcotic consumption, and superior discharge range of motion. Older age independently predicted catheter selection, whereas longer operative time and continued opioid use favored nerve block utilization.