Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

Abstract

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

Patient-reported Outcome and Quality of Life after Treatment with External Fixation: A Questionnaire-based Survey

“…It is also imperative to consider robust pain control, albeit temporary, in the immediate post-operative period including the use of nerve blocks. 19 …”

The Efficacy and Safety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-analysis

“…Otherwise, the xed effects model was used.Only a CI was provided in two studies [19][20] , the SD was calculated using the following formula where U refers to the upper limit of the CI, u to the mean, s to the SD and n to the number of study participants in each group. U-u=s/sqrt(n) 2 When P < 0.05 was considered signi cant. Sensitivity analysis was used to nd potential sources of signi cant heterogeneity.…”

“…Total hip arthroplasty (THA) is considered to be the most effective surgical treatment for patients with severe hip disease [1][2]. In spite of the satisfactory results of THA, because patients suffer blood loss during the perioperative period, surgery carries risks of postoperative anemia and blood transfusion, leading to longer hospital stays and higher medical costs [3][4].…”

Opioid Use Consequences, Governmental Strategies, and Alternative Pain Control Techniques Following Total Hip Arthroplasties

“…76 A study performed by Nishio et al has indicated that combination sciatic and femoral nerve block offers adequate analgesia, on the basis of reported pain scores at 6and 12-hour time points in patients undergoing THA. 77 Recent evidence has suggested that nerve block analgesia for patients after THA should be avoided in favor of systemic analgesia, owing to onset of low extremity weakness. 76 Specifically, in up to 90% of cases following femoral nerve block or quadratus lumborum block, there is onset of significant quadriceps weakness, in which case the adverse consequences of falling may significantly outweigh the benefit of analgesia.…”