This study aimed to examine the impact of preoperative lumbar plexus blockade on perioperative analgesia and opioid consumption following hip arthroscopy. The records of patients (n = 236) who underwent hip arthroscopy between July 27, 2004 and November 15, 2009 were reviewed (118 patients with preoperative lumbar plexus block and 118 procedure matched patients without a preoperative block). Baseline patient characteristics were similar between groups. Immediate post-anaesthesia care unit (PACU) pain scores, peak PACU pain scores, perioperative opioid administration, and PACU antiemetic administration favoured preoperative block placement. Postoperative modified Harris Hip scores and postoperative day one pain scores were similar between groups. Total hospital time following the surgical procedure was longer in the block group. While preoperative lumbar plexus blockade may be helpful for analgesia following hip arthroscopy, more research needs to be done to determine the ideal analgesic regimen for these patients.

Background: Outcomes after migraine surgery have been previously assessed using quantitative measurements, including the migraine headache index. Qualitative methodologies offer the ability to analyze patients’ perceptions and pain experience, and may point to changes in domains not captured by quantitative instruments. The purpose of this study was to characterize individual patients’ experiences with migraines and to analyze how patients’ experience of headaches changes in relation to surgery. Methods: Patients who previously underwent migraine surgery performed by a single surgeon participated in semistructured interviews at least 1 year after surgery. Purposive sampling was used to recruit patients [n = 15 (73 percent female)]. Interviews were transcribed verbatim. A multidisciplinary team with backgrounds in surgery, pain management, medicine, and health services research coded and analyzed transcripts. Results: Participants reported improvements in one or more domains of pain following surgery, and changes in medication use and effectiveness. Even in individuals with persistent pain postoperatively, surgery appeared to facilitate an improvement in headache self-efficacy, including an ability to participate in daily activities. Migraineurs frequently described a new degree of control over at least one aspect of their pain. Conclusions: Migraine surgery appears to positively impact patients’ lives in ways that support and expand on previously published outcomes. Patients report benefiting from surgery in ways that are not currently captured in commonly used metrics. This study’s findings support the need for more specific patient-reported outcome measures to help clinicians and patients understand the impact of surgery and which outcomes matter most to patients.