CLINICAL CASE: THE USE OF FEMORAL AND SCIATIC NERVE BLOCK COMBINATION IN PAIN MANAGEMENT AFTER TOTAL KNEE ARTHROPLASTY

NIKOLOZ KACHIBAIA; VAKHTANG GODERDZISHVILI

doi:10.52340/jecm.2025.06.32

CLINICAL CASE: THE USE OF FEMORAL AND SCIATIC NERVE BLOCK COMBINATION IN PAIN MANAGEMENT AFTER TOTAL KNEE ARTHROPLASTY

Authors

NIKOLOZ KACHIBAIA Tbilisi State University
VAKHTANG GODERDZISHVILI Tbilisi State University

DOI:

https://doi.org/10.52340/jecm.2025.06.32

Keywords:

Total knee arthroplasty, Femoral nerve block, Sciatic nerve block, Pain

Abstract

Total knee arthroplasty (TKA) is frequently associated with significant postoperative pain, which can impair early rehabilitation and increase opioid consumption. Femoral nerve block (FNB) is widely used to manage anterior knee pain but may cause quadriceps weakness and does not reliably cover posterior knee innervation. The addition of a sciatic nerve block (SNB) may enhance analgesic efficacy by targeting posterior knee structures. However, concerns remain regarding potential motor deficits, including foot drop. This case report presents two patients who underwent unilateral TKA and received a combined femoral and sciatic nerve block after confirming full return of motor function, aiming to optimize postoperative analgesia while minimizing neurological risks.

Unlike traditional protocols in which nerve blocks are performed preoperatively or immediately at the end of surgery, these cases utilized a delayed block technique - administering FNB and SNB after confirmation of restored foot motor function. This approach allows early detection of surgical nerve injury and reduces the risk of masking postoperative complications such as foot drop.

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Author Biographies

NIKOLOZ KACHIBAIA, Tbilisi State University

Iv. Javakhishvili Tbilisi State University

Acad. Fridon Todua Medical Center

VAKHTANG GODERDZISHVILI, Tbilisi State University

Iv. Javakhishvili Tbilisi State University

American Hospital

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