The purpose of this study was to compare the analgesic effect of 0.25% and 0.5% levobupivacaine for real time ultrasound guided single-injection femoral nerve block for the patients who are undergoing bilateral total knee arthroplasty (TKA). Methods: Femoral nerve block was done to all patients with 20 ml of 0.9% normal saline on one leg and 20 ml of 0.25% levobupivacaine on the other leg for group I (n = 16) and 0.5% levobupivacaine for group II (n = 15) with 1:200,000 epinephrine and using

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... l-time ultrasound and a nerve stimulator. The data concerning the verbal numerical rating scale (VNRS) for each leg, the consumption of the intravenous patient-controlled analgesia (IV PCA) and the demands for the additional analgesics was collected at 0, 1, 6, 12, 24 and 48 hours after the operation. Results: The legs on which femoral nerve block was done with levobupivacaine showed a lower VNRS score than the legs with normal saline in either group I or group II. The VNRS scores between the two legs, the consumption of the IV PCA and the demand for additional analgesics showed no significant differences between the groups. Conclusions: Our results demonstrate that single-injection femoral nerve block using real-time ultrasound with either 0.25% levobupivacaine or 0.5% levobupivacaine 20 ml provides a good effect for the postoperative pain control after TKA. (Korean J Pain 2009; 22: 234-240) Key Words: femoral nerve block, levobupivacaine, total knee arthroplasty, ultrasound. 서 론 슬관절 전치환술은 수술 후 극심한 통증을 나타내며, 조기 재활치료가 필요하여 수술 후 통증조절이 필수적 인 수술이다. 퇴행성 관절염으로 인해 수술을 받게 되는 특성상 대부분의 환자들이 고령으로, 척추의 퇴행성 변 형이 심하거나 신경학적 증상을 동반한 경우가 많다. 이