Les concentrations plasmatiques de ropivacaïne sont similaires pendant le bloc continu du plexus lombaire réalisé par voie antérieure trois- en- un et par voie postérieure de la loge du psoas

Kaloul, Ismaïl; Guay, Joanne; Côté, Christiane; Halwagi, Antoine

doi:10.1007/bf03018547

Cited by 34 publications

(15 citation statements)

References 14 publications

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“…26 mg/h for both catheters. Even though Kaloul et al (2004b) found potentially toxic levels when 24 mg/h was infused, no signs of toxicity were observed in our study. Even 28 mg/h did not cause symptoms in a study by Morin et al (2005).…”

Section: Discussioncontrasting

confidence: 83%

Continuous psoas and sciatic block after knee arthroplasty: good effects compared to epidural analgesia or i.v. opioid analgesia: A prospective study of 63 patients

et al. 2007

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Introduction For endoprosthetic knee surgery, intensive postoperative pain therapy is necessary. We therefore evaluated whether the combination of continuous psoas compartment and sciatic analgesia (PSC) is as effective as epidural analgesia (EPI) and whether it provides better analgesia than patient-controlled intravenous analgesia with piritramide (PCA).Methods We studied 63 patients who underwent total knee arthroplasty (TKA). The PSC group received a combination of continuous psoas and sciatic nerve block, the EPI group an epidural analgesia, and the PCA group an intravenous patient-controlled piritramide pump. Pain scores, satisfaction, flexion and side effects were recorded.Results Pain scores (0-10) were higher in the PCA group (on movement, day 1/day 2: 7.0/6.5) than in the EPI group (5.0/5.0) and the PSC group (4.0/3.5). Postoperative opioid consumption over 48 h was higher in the PCA group (51 mg) than in the EPI group (0 mg) and the PSC group (0 mg). There were no differences in functional recovery. Pruritus occurred more frequently in the PCA and EPI groups than in the PSC group. Patients receiving a PSC and EPI were more satisfied than those treated with PCA.Interpretation Analgesia with PSC catheters or EPI catheter is superior to PCA regarding pain levels, analgesic requirements, and patient satisfaction. There

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Section: Discussioncontrasting

confidence: 83%

Continuous psoas and sciatic block after knee arthroplasty: good effects compared to epidural analgesia or i.v. opioid analgesia: A prospective study of 63 patients

et al. 2007

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“…From the literature available to date, the maintenance of a catheter for longer than 36 hr probably increases the risks for the patient without any clearly demonstrable benefit over iv PCA. 24,25 In conclusion, no differences in analgesia were seen between continuous PSOAS (psoas compartment) blockade and continuous three-in-one FEM blockade for postoperative pain relief in patients undergoing TKR. As the former has been associated with severe complications, the latter may be the regional anesthetic technique of choice in patients undergoing TKR.…”

Section: Discussionmentioning

confidence: 85%

“…Furthermore, maintenance of a catheter for a duration of 48 hr may increase the risks of infection and, depending on the rate and concentration of the local anesthetic used, may result in local anesthetic toxicity. 24,25 The first question was addressed in a study that compared a control group without regional anesthesia, a group with a single-shot FEM block, and a group with a continuous FEM block. 26 Compared to the control group, a reduction in dynamic VAS pain scores was seen in the groups with FEM blockade only in the recovery room.…”

Section: Discussionmentioning

confidence: 99%

The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement

Kaloul

Guay

Côté

et al. 2004

Can J Anesth/J Can Anesth

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106

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P Pu ur rp po os se e: : To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR).M Me et th ho od ds s: : Sixty patients were randomly allocated to receive iv patient-controlled morphine analgesia (PCA), PCA plus a continuous FEM block with 30 mL ropivacaine 0.5% and epinephrine 1:200,000 bolus followed by an infusion of ropivacaine 0.2% at 12 mL·hr -1 for 48 hr, or PCA plus a continuous PSOAS block with the same bolus and infusion regimen as the FEM group. Postoperative morphine consumption, verbal analogue scale pain scores at rest and during physiotherapy, and evidence of sensory and motor blockades were noted. R Re es su ul lt ts s: : Both regional techniques significantly reduced 48 hr morphine consumption (FEM 37.3 ± 34.7 mg, P = 0.0002; PSOAS 36.1 ± 25.8 mg, P < 0.0001) compared to PCA (72.2 ± 26.6 mg). Pain scores at rest, six and 24 hr after TKR were lower in the FEM and PSOAS groups compared to the PCA group (P < 0.0001). Although sensory and motor blockades of the obturator nerve were achieved more often in the PSOAS group than in the FEM group (P < 0.0001), morphine consumption and pain scores did not differ between the two groups.C Co on nc cl lu us si io on n: : Both continuous PSOAS block and continous threein-one FEM block provided better analgesia than PCA but no differences were seen between the two regional techniques.

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“…Although the safety of continuous infusion is reported, it may lead to the accumulation of the local anesthetic that is administered at large volumes and had a potential risk of toxicity after prolonged periods of infusions [7,8]. There were no clinical symptoms or signs of local anesthetic toxicity during the study period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Continuous Epidural Analgesia and Continuous Femoral Analgesia on Postoperative Pain and Knee Rehabilitation after Total Knee Arthroplasty

Erdogan¹,

Şavlı²,

Kaya³

et al. 2014

IJAR

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Les concentrations plasmatiques de ropivacaïne sont similaires pendant le bloc continu du plexus lombaire réalisé par voie antérieure trois- en- un et par voie postérieure de la loge du psoas

Cited by 34 publications

References 14 publications

Continuous psoas and sciatic block after knee arthroplasty: good effects compared to epidural analgesia or i.v. opioid analgesia: A prospective study of 63 patients

Continuous psoas and sciatic block after knee arthroplasty: good effects compared to epidural analgesia or i.v. opioid analgesia: A prospective study of 63 patients

The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement

Comparison of Continuous Epidural Analgesia and Continuous Femoral Analgesia on Postoperative Pain and Knee Rehabilitation after Total Knee Arthroplasty

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