Continuous femoral nerve analgesia after unilateral total knee arthroplasty: stimulating versus nonstimulating catheters

Anesth Analg. 2006 Dec;103(6):1565-70. doi: 10.1213/01.ane.0000244476.38588.c9.


Background: Continuous femoral analgesia provides extended pain relief and improved functional recovery for total knee arthroplasty (TKA). Stimulating catheters may allow more accurate placement of catheters.

Methods: We performed a randomized prospective study to investigate the use of stimulating catheters versus nonstimulating catheters in 41 patients undergoing TKA. All patients received i.v. patient-controlled anesthesia for supplementary pain relief. The principal aim of the trial was to examine whether a stimulating catheter allowed the use of lesser amounts of local anesthetics than a nonstimulating catheter. The additional variables we examined included postoperative pain scores, opioid use, side effects, and acute functional orthopedic outcomes.

Results: Analgesia was satisfactory in both groups, but there were no statistically significant differences in the amount of ropivacaine administered; the median amount of ropivacaine given to patients in the stimulating catheter group was 8.2 mL/h vs 8.8 mL/h for patients with nonstimulating catheters, P = 0.26 (median difference -0.6; 95% confidence interval, -2.3 to 0.6). No significant differences between the treatment groups were noted for the amount of fentanyl dispensed by the i.v. patient-controlled anesthesia, numeric pain rating scale scores, acute functional orthopedic outcomes, side effects, or amounts of oral opioids consumed.

Conclusion: The use of stimulating catheters in continuous femoral nerve blocks for TKA does not offer significant benefits over traditional nonstimulating catheters.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amides / administration & dosage
  • Analgesia, Patient-Controlled
  • Arthroplasty, Replacement, Knee*
  • Catheterization / methods*
  • Female
  • Femoral Nerve*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / therapy*
  • Prospective Studies
  • Ropivacaine


  • Amides
  • Ropivacaine