Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. a prospective, randomized, double-blind study

Biboulet, Philippe; Morau, Didier; Aubas, P; Bringuier-Branchereau, Sophie; Capdevila, Xavier

doi:10.1016/j.rapm.2003.11.006

Cited by 102 publications

(110 citation statements)

References 22 publications

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“…Most patients of both groups were discharged in the third postoperative day and almost all patients of the sample were discharged before the fourth postoperative day. Our results are different from studies suggesting that cLPB speeds postoperative recovery 8,13 , suggesting that recovery times are similar for both groups. Reports of severe complications and familiarity with other techniques may explain the reluctance of anesthesiologists in choosing LPB.…”

Section: Discussioncontrasting

confidence: 99%

Postoperative analgesia for hip arthroplasty: comparison of continuous lumbar plexus block and epidural analgesia

Costa¹,

Carvalho²,

Castro³

et al. 2016

Revista Dor

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BACKGROUND AND OBJECTIVES:Postoperative pain after total hip arthroplasty is moderate to severe and requires effective analgesic techniques. This study aimed at comparing continuous lumbar plexus block and epidural analgesia in patients submitted to hip arthroplasty. METHODS: This is a prospective, observational and analytical study of patients submitted to hip arthroplasty in a two-year period, under postoperative analgesia with continuous lumbar plexus block and epidural analgesia. Patients were divided according to the analgesic technique chosen by the anesthesiologist. The protocol consists in continuous perfusion of 0.2% ropivacaine (5mL/h) via continuous lumbar plexus block catheter or 0.1% ropivacaine and fentanyl (3µg/mL) (5mL/h) via epidural catheter. Using Acute Pain Unit records, three postoperative days were compared between continuous lumbar plexus block and epidural analgesia with regard to pain intensity, rescue analgesia, complications and hospital stay. RESULTS: Participated in the study 162 patients. Most patients of both groups had no pain in the first postoperative day (77.6% continuous lumbar plexus block versus 79.2% epidural). Both groups were not different with regard to pain intensity and need for rescue analgesia (23.5% continuous lumbar plexus block versus 22.1% epidural). Continuous lumbar plexus block group had fewer complications (4.7% versus 23.4%), namely motor block, nausea, vomiting and itching. The low number of complications does not allow the detection of significant differences between techniques. Most patients of both groups were discharged in the third postoperative day. Postoperative analgesia for hip arthroplasty: comparison of continuous lumbar plexus block and epidural analgesia

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Section: Discussioncontrasting

confidence: 99%

Postoperative analgesia for hip arthroplasty: comparison of continuous lumbar plexus block and epidural analgesia

Costa¹,

Carvalho²,

Castro³

et al. 2016

Revista Dor

View full text Add to dashboard Cite

show abstract

“…There was no significant difference in the degree of analgesia in the two groups in the first and second postoperative hour, as well as 12 hours after surgery, during rest and during hip flexion. There are a few studies on the effect of single and continuous FNB block as a perioperative analgesia in patients with hip fracture [13,15,16,18,19]. Sirvastativa et al [15] investigated the single FNB block versus psoas compartment block as an analgesia after hip surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Lumbar plexus block and blocks of its branches provide excellent analgesia. Blocking plexus lumbalis is performed by rear paravertebral (psoas compartment block) and anterior inguinal paravascular access (n. femoralis block, known as the "3-in-1" block) [13]. An anterior approach provides a simultaneous blockade of n. femoralis, n. cutaneus femoris lateralis and n. Obturatorius; therefore, this technique is called "3-in-1".…”

Section: Doi: 102478/prilozi-2014-0011mentioning

confidence: 99%

Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture

Temelkovska-Stevanovska

Durnev

Jovanovski-Srceva

et al. 2014

Prilozi

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Introduction: Systemic postoperative analgesia is inefficient in most patients with hip fracture, which is the reason for pain, especially during leg movement. Peripheral and plexus nerve blocks are an efficient option for postoperative pain relief. The aim of this study was to compare the effect and duration of continuous FNB versus a single FIC block as a postoperative analgesia in patients with hip fracture. Methods: Sixty patients with hip fracture were included and were randomly assigned to two groups of 30 patients: FNB group -patients with continuous femoral nerve block; and FIC group -patients with a single fascia iliaca compartment block. In all patients, pain intensity was measured at rest and in passive leg movement by using VDS (0-4) at several intervals: 1, 2, 12, 24, 36 and 48 hours after intervention. The amount of supplemental analgesia was measured, together with the time when the patient needed it for the first time, as well as the side effects. Results: The values of VDS were significantly lower in patients with FNB block versus patients with FIC block in rest and movement at the 24-hour intervals (46.67% vs 0% felt moderate pain), after 36 hours (43.33% vs 0% felt moderate pain) and 48 hours after intervention (46.67% vs 3.33% felt moderate to severe pain) for p < 0.05. Patients with FNB block received a significantly lower amount of supplemental analgesia, 23.3% of the FNB group vs 50% of the FIC group (p < 0.05). Registered side effects were were nausea, dizziness and sedation, and they were statistically significantly more frequent in the FIC group (p < 0.05). Conclusion: Pain relief in the postoperative period was superior in the FNB group versus the FIC group at rest and in movement in patients with hip fracture.

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“…7,10 However, in 45 patients undergoing total hip replacement, one study compared single shot lumbar plexus and 3-in-1 blocks and failed to detect any difference in nerve block distribution. 13 Two RCTs (combined n = 119) have compared continuous posterior and anterior approaches for patients undergoing total knee replacement. While Morin et al 14 reported similar performance time, onset and success of obturator sensory blockade, Kaloul et al 15 found a better sensory block of the obturator nerve at 24 hr (P = 0.02).…”

Section: Approachesmentioning

confidence: 99%

“…13,14,23 Thus we decided to include the results of these RCTs in the previous section. A review of the literature yielded only one RCT corresponding to our search criteria.…”

Section: Femoral Nerve Blockmentioning

confidence: 99%

A review of approaches and techniques for lower extremity nerve blocks

Tran

Clemente

Finlayson

2007

Can J Anesth/J Can Anesth

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Purpose: The purpose of this narrative review is to summarize the evidence derived from randomized controlled trials (RCTs) regarding approaches and techniques for lower extremity nerve blocks.Source: Using the MEDLINE (January 1966 to April 2007 and EMBASE (January 1980 to April 2007 databases, medical subject heading (MeSH) terms "lumbosacral plexus", "femoral nerve", "obturator nerve", "saphenous nerve", "sciatic nerve", "peroneal nerve" and "tibial nerve" were searched and combined with the MESH term "nerve block" using the operator "and". Keywords "lumbar plexus", "psoas compartment", "psoas sheath", "sacral plexus", "fascia iliaca", "three-in-one", "3-in-1", "lateral femoral cutaneous", "posterior femoral cutaneous", "ankle" and "ankle block" were also queried and combined with the MESH term "nerve block". The search was limited to RCTs involving human subjects and published in the English language. Forty-six RCTs were identified. Principal findings:Compared to its anterior counterpart (3-in-1 block), the posterior approach to the lumbar plexus is more reliable when anesthesia of the obturator nerve is required. The fascia iliaca compartment block may also represent a better alternative than the 3-in-1 block because of improved efficacy and efficiency (quicker performance time, lower cost). For blockade of the sciatic nerve, the classic transgluteal approach constitutes a reliable method. Due to a potentially shorter time for sciatic nerve electrolocation and catheter placement than for the transgluteal approach, the subgluteal approach should also be considered. Compared to electrolocation of the peroneal nerve, electrostimulation of the tibial nerve may offer a higher success rate especially with the transgluteal and lateral popliteal approaches. Furthermore, when performing sciatic and femoral blocks with low volumes of local anesthetics, a multiple-injection technique should be used. MeSH « nerve block » à l'aide de l'opérateur « and ». Les mots clés « lumbar plexus », « psoas compartment », « psoas sheath », « sacral plexus », « fascia iliaca », « lateral Conclusions Objectif : L'objectif de cet examen narratif est de résumer les données probantes dérivées d'études randomisées contrôlées (ERC) concernant les approches et techniques pour les blocs nerveux du membre inférieur. Source : A l'aide des bases de données MEDLINE (janvier 1966 à avril 2007) et EMBASE (janvier 1980 à avril 2007), les termes MeSH (vedette-matière médicale) « lumbosacral plexus », « femoral nerve », « obturator nerve », « saphenous nerve », « sciatic nerve », « peroneal nerve » et « tibial nerve » ont été recherchés et combinés au terme

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Postoperative analgesia after total-hip arthroplasty: comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. a prospective, randomized, double-blind study

Abstract: PCA is an efficient and safe analgesia technique. FNB and PCB should not be used routinely after total-hip arthroplasty.

Cited by 102 publications

References 22 publications

Postoperative analgesia for hip arthroplasty: comparison of continuous lumbar plexus block and epidural analgesia

Postoperative analgesia for hip arthroplasty: comparison of continuous lumbar plexus block and epidural analgesia

Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture

A review of approaches and techniques for lower extremity nerve blocks

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