Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

Bergmann, Ingo; Heetfeld, Maximilian; Crozier, T. A.; Schafdecker, Hans G.; Pöschl, Rupert; Wiese, C.H.R.; Popov, Aron F.; Bauer, Martin; Hinz, José

doi:10.2478/s11536-012-0143-4

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…We too found similar results. 23 In this study, the mean arterial pressures increased in the control group, but this difference was not significant. This could be because, as soon as pain increased (VAS>3), supplemental systemic analgesia was provided.…”

Section: Discussioncontrasting

confidence: 58%

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

Shukla¹,

Jahan²,

Naaz³

et al. 2018

Int J Res Med Sci

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Background: Adequate postoperative analgesia facilitates early mobilization which is important to reduce postoperative morbidity. Here, we intended to compare the efficacy of two different nerve blocks for postoperative pain relief in fractured neck of femur patients. Methods: One hundred and five patients posted either for dynamic hip screw or proximal femoral nail implantation under spinal anaesthesia were randomly allocated to three groups. At the end of surgery, group 1 received femoral nerve block (FNB) and group 2 received fascia iliaca compartment block (FICB) for postoperative pain relief. These blocks were ultrasound guided. Group 3 received no block and acted as control. Patients' pain was evaluated by Visual Analogue Scale (VAS) both at rest and at passive elevation of leg. Rescue analgesia was given when VAS score exceeded 3. Heart rate, mean arterial blood pressure, respiratory rate and total analgesic consumption in first 24 hours were also recorded. Results: Groups 1 and 2 had similar duration of analgesia of around 8 hours (P value = 0.727). Analgesic consumption in both these groups were similar (P value = 0.648). These groups had less pain, less analgesic requirement and more stable haemodynamics as compared to group 3. No adverse effect was seen due to application of block. Conclusions: FICB can be an effective alternative to femoral nerve block, because of its relative simplicity in technique and less invasiveness. Hence FICB holds considerable promise as an effective postoperative analgesia.

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Section: Discussioncontrasting

confidence: 58%

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

Shukla¹,

Jahan²,

Naaz³

et al. 2018

Int J Res Med Sci

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“…Ultrasound-guided peripheral nerve blocks remains a safe alternative for such patients. [1213] There are few case reports based on lower limb surgeries performed under peripheral nerve blocks. Baddoo et al .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided popliteal sciatic and adductor canal block for below-knee surgeries in high-risk patients

et al. 2019

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Background and Aims: Central neuraxial block and general anaesthesia in patients with significant comorbidities are associated with considerable peri-operative morbidity and mortality. This study aims to delineate peripheral nerve block as a suitable alternative technique in high-risk patients posted for below-knee surgery. Methods: Twenty patients with the American Society of Anesthesiologist's (ASA) physical status grade III and IV, aged 30–80 years, scheduled for below-knee surgery from May 2018 to February 2019 were enrolled in this prospective study. All patients received ultrasound-guided popliteal sciatic block with 20 ml 0.5% ropivacaine and adductor canal block with 10 ml 0.375% ropivacaine. The peripheral nerve block success rate, sensory and motor block onset time, haemodynamic parameters, duration of post-operative analgesia and patient's satisfaction were recorded. Descriptive statistics of the study were calculated and the data was analysed using an SPSS statistics 21.0 program. Result: Surgery was performed successfully with no additional analgesic requirement in all patients. The mean duration for sensory and motor block onset time was 3.35 ± 0.49 (mean ± standard deviation) and 4.65 ± 0.48 (mean ± standard deviation) minutes respectively. Haemodynamic parameters were maintained stable throughout the procedure. The average duration of postoperative analgesia was 7.5 ± 0.8 (mean ± standard deviation) hours. Patient overall satisfaction as assessed, by three-point Lickert's scale, was satisfactory. Conclusion: Ultrasound-guided combined popliteal sciatic and adductor canal block is an effective alternative anaesthetic technique for below-knee surgeries with stability of haemodynamic parameters and pain management in high-risk patients.

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“…PNB give greater hemodynamic stability than any other anesthetic techniques. [161718] Figure 1 showed stable hemodynamic trend over 120 minutes after receiving PNB. Only 18% of the cases required some amount of vasopressor during operation, and that could be due to the usage of higher sedation-analgesia, and patients had limited cardiovascular reserve and bleeding during operation.…”

Section: Discussionmentioning

confidence: 95%

“…Only 18% of the cases required some amount of vasopressor during operation, and that could be due to the usage of higher sedation-analgesia, and patients had limited cardiovascular reserve and bleeding during operation. PNB has also proven to provide excellent anesthesia and analgesia[171819] for a variety of surgeries, with a particular benefit on those undergoing the upper and lower extremity surgeries. [720]…”

Section: Discussionmentioning

confidence: 99%

Peripheral nerve blocks for above knee amputation in high-risk patients

Chandran

Beh

Tsai

et al. 2018

J Anaesthesiol Clin Pharmacol

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Background and Aims:Above knee amputation (AKA) is associated with considerable mortality and morbidity. There is paucity of data describing the use of peripheral nerve blocks (PNB) as the sole anesthetic technique in high-risk patients undergoing AKA. Our objectives were to evaluate the use of PNB as sole anesthetic technique in the above-mentioned population and its clinical outcomes.Material and Methods:This was a retrospective descriptive study conducted in a tertiary hospital. For this study, patients with American Society of Anesthesiologist [ASA] IV physical status underwent AKA using PNB between January 2010 and December 2016, were identified. The primary outcome measured was the success of the operation. The secondary outcomes were block details, intraoperative hemodynamics, usage of sedation and analgesia, patients’ comorbidities, mortality rates at 30 days and one year.Results:Out of fifty-seven patients, the median age (interquartile range) was 74 (57 – 81) years and 60% were males. The results show 91% successfully underwent surgery with PNB (95% CI 81% to 96%). 95% required intraoperative sedation and analgesia. 67% received combined femoral, obturator and sciatic nerve blocks, in which nine cases had an additional lateral femoral cutaneous nerve block. Interestingly, 33% only received combined femoral and sciatic nerve blocks, and they required higher sedation analgesia (p = 0.013). The 30-day and one-year mortality were 12.3% & 47.4%. Majority had stable hemodynamics during the surgery.Conclusion:This study shows that PNB is a viable option for reliable anesthesia for AKA in high-risk patients. Combined FOS nerve block would reduce the dose for sedation–analgesia during the operation.

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Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

Abstract: Abstract

Cited by 10 publications

References 22 publications

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

Ultrasound-guided popliteal sciatic and adductor canal block for below-knee surgeries in high-risk patients

Peripheral nerve blocks for above knee amputation in high-risk patients

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