The Effect of Intra-articular Cocktail Versus Femoral Nerve Block for Patients Undergoing Hip Arthroscopy

Childs, Sean; Pyne, Sonia; Nandra, Kiritpaul; Bakhsh, Wajeeh; Mustafa, Suzana; Giordano, Brian D.

doi:10.1016/j.arthro.2017.06.036

Cited by 28 publications

(20 citation statements)

References 30 publications

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“…Childs et al 20 compared intraoperative intra-articular blockade to preoperative femoral nerve block in patients who underwent hip arthroscopy. The authors reported that femoral nerve blocks were more effective for controlling pain in the immediate postoperative period however, femoral nerve blocks were also associated with an increased rate of postoperative falls and iatrogenic peripheral neuritis.…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported that femoral nerve blocks were more effective for controlling pain in the immediate postoperative period however, femoral nerve blocks were also associated with an increased rate of postoperative falls and iatrogenic peripheral neuritis. 20 Intra-articular injection has shown to provide effective postoperative pain management and reduced rates of the above mentioned complications. 20 Despite the chondrotoxic potential of intraarticular blockade, avoiding postoperative falls and iatrogenic peripheral neuritis in day-case-surgeries remains advantageous.…”

Section: Discussionmentioning

confidence: 99%

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Preemptive analgesia in hip arthroscopy: intra-articular bupivacaine does not improve pain control after preoperative peri-acetabular blockade

et al. 2020

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Introduction: Literature addressing postoperative pain management after hip arthroscopy is relatively scarce. This study aimed to assess if there was added analgesic benefit associated with postoperative intra-articular bupivacaine blockade for patients who received preoperative peri-acetabular blockade for hip arthroscopy procedures. Methods: 52 patients were included in this comparative cohort study. Group 1 consisted of 20 patients who received preoperative peri-acetabular blockade and postoperative intra-articular blockade. The control group (Group 2), consisted of 32 patients who received only preoperative peri-acetabular blockade. Postoperative pain was recorded via visual analogue scale (VAS) pain scores, analgesic consumption, and pain diaries for 2 weeks postoperatively. Results: Postoperative VAS pain scores were significantly lower in the experimental group at the 30-minute recovery room assessment (VAS scores Group 1: 1.1; Group 2: 3.00, p = 0.034). Other than the 30-minute recovery room assessment, VAS pain scores, narcotic medication consumption, and non-narcotic analgesic consumption did not differ between the 2 groups at any time point in the study period. Conclusions: This study did not demonstrate significant clinical benefit for patients who receive postoperative intra-articular blockade in addition to preoperative peri-acetabular blockade with bupivacaine 0.5%. We recommend the use of preoperative peri-acetabular bupivacaine blockade without intra-articular blockade postoperatively for pain control in the setting of hip arthroscopy surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preemptive analgesia in hip arthroscopy: intra-articular bupivacaine does not improve pain control after preoperative peri-acetabular blockade

et al. 2020

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“…Local intra-articular (IA) anesthetic injections have proved similarly successful relative to FNB. Childs S, et al [14], recorded no major difference between FNB and pain scores for 1, 3 and 6 weeks. Importantly, postoperative drops were slightly smaller in the IA injection community (5 versus 19, p <0,001).…”

Section: Important Conclusionmentioning

confidence: 90%

“…Although peripheral nerve blocks can alleviate postoperative pain effectively, they are not complicated. Intravascular injection, iatrogenic nerve trauma, postoperative slips, inflammation and rebound pain following discharge are risk for peripheral nerve blocks [13][14][15]. Furthermore, peripheral nerve blocks require specialist instruments and an anesthesiologist to operate them and raise patient and hospital costs.…”

Section: Important Conclusionmentioning

confidence: 99%

Pain Management Strategies Postoperatively in Arthroscopy of Hip: A review Article

LaPorte¹

2021

ARAR

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“…An a priori power analysis was performed based on the results of previous literature on pain scores after hip arthroscopic surgery. 10 It was determined that a minimum of 26 patients per group was required to power the study to 1 – β = 0.80, and therefore, groups of 35 patients each were selected to ensure adequate power. A post hoc power analysis conducted for the postoperative pain scores between the 2 groups resulted in a power value of 100%.…”

Section: Methodsmentioning

confidence: 99%

Use of Air Arthrograms to Aid in Joint Distraction During Hip Arthroscopic Surgery Decreases Postoperative Pain and Opioid Requirements

Hodax

Flores

Cheung

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Positive-pressure air arthrography and venting of the hip capsule are techniques used to decrease the traction forces needed for joint distraction during hip arthroscopic surgery. Little is known about the effects that these techniques have on postoperative pain. Hypothesis: Positive-pressure air arthrography and venting during hip arthroscopic surgery will decrease patient-reported pain and narcotic requirements in the acute postoperative setting. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort analysis was conducted to analyze 35 patients who underwent positive-pressure air arthrography and venting to aid joint distraction during hip arthroscopic surgery versus a group with similar demographics, pathologies, and treatments who did not undergo air arthrography. Numeric pain rating scale (NPRS) scores and medication administration including narcotic and nonnarcotic analgesia in the postanesthesia care unit (PACU) were tracked and compared. Results: The maximum (7.17 vs 4.97, respectively), minimum (2.43 vs 1.09, respectively), and mean (5.15 vs 3.11, respectively) NPRS scores were all higher in the control group compared with the air arthrogram group ( P < .001, P = .007, and P < .001, respectively). The administration of oral morphine equivalents (OMEs) during the PACU stay was significantly lower in the air arthrogram group, with a mean of 36.75 ± 11.37 OMEs, compared with 44.53 ± 16.06 OMEs in the control group ( P = .023). There was no difference in postoperative nonopioid medications, such as ketorolac or acetaminophen, given between groups. Conclusion: Patients undergoing hip arthroscopic surgery with air arthrography and venting used to aid distraction had significantly less postoperative pain and required a lower total dosage of opioids during their PACU stay when compared with patients who underwent hip arthroscopic surgery without air arthrography.

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The Effect of Intra-articular Cocktail Versus Femoral Nerve Block for Patients Undergoing Hip Arthroscopy

Cited by 28 publications

References 30 publications

Preemptive analgesia in hip arthroscopy: intra-articular bupivacaine does not improve pain control after preoperative peri-acetabular blockade

Preemptive analgesia in hip arthroscopy: intra-articular bupivacaine does not improve pain control after preoperative peri-acetabular blockade

Pain Management Strategies Postoperatively in Arthroscopy of Hip: A review Article

Use of Air Arthrograms to Aid in Joint Distraction During Hip Arthroscopic Surgery Decreases Postoperative Pain and Opioid Requirements

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