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

Raimer, Constance; Priem, Kristin; Wiese, A.; Birnbaum, Jürgen; Dirkmorfeld, Larissa M; Mossner, Andrea; Matziolis, Georg; Perka, Carsten; Volk, Thomas

doi:10.1080/17453670710013672

Cited by 22 publications

(19 citation statements)

References 20 publications

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“…Raimer et al recorded that patient satisfaction with the anesthetic technique was high, and no significant differences were observed between psoas compartment-sciatic analgesia and epidural analgesia for postoperative pain therapy after knee arthroplasty 19. We investigated satisfaction of both the patients and the surgeons.…”

Section: Discussionmentioning

confidence: 95%

A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

Horasanlı¹,

Gamlı²,

Pala

et al. 2010

Clinics

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OBJECTIVES:The efficacy of combined lumbar plexus-sciatic nerve blocks was compared to epidural anesthesia in patients undergoing total knee surgery.PATIENTS AND METHODS:The study included 80 American Society of Anesthesiologists (ASA) Physical Status I–III patients (age range 18 to 65) undergoing knee surgery. The patients were randomly divided into one of two groups. Epidural anesthesia was performed in the epidural anesthesia (EA) group (n=40), and the lumbar plexus and sciatic nerves were blockedin the lumbar plexus-sciatic nerve blocks (LPSB) group (n=40). For each patient, onset of sensory and motor block, degree of motor block, sign of sensory block in the contralateral lower limb for the lumbar plexus-sciatic nerve blocks group, success in providing adequate anesthesia, hemodynamic changes, time of first analgesic request, and patient and surgeon satisfaction with the anesthetic technique were recorded.RESULTS:One patient in the epidural anesthesia group and three patients in the lumbar plexus-sciatic nerve blocks group required general anesthesia due to failed block. There were no significant differences between the two groups regarding the success of providing adequate anesthesia. Eight patients in the lumbar plexus-sciatic nerve blocks group developed contralateral spread. The onset of sensory-motor block and the time of the first analgesic request were significantly later in the lumbar plexus-sciatic nerve blocks group than in the epidural anesthesia group. Although there were no significant differences regarding patient satisfaction with the anesthetic technique between the two groups, surgeon satisfaction was significantly higher in the lumbar plexus-sciatic nerve blocks group than in the epidural anesthesia group.CONCLUSION:The lumbar plexus -sciatic nerve blocks provide effective unilateral anesthesia and may offer a beneficial alternative to epidural anesthesia in patients undergoing total knee surgery.

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Section: Discussionmentioning

confidence: 95%

A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

Horasanlı¹,

Gamlı²,

Pala

et al. 2010

Clinics

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“…Contrary, Raimer et al described better analgesia with continuous psoas and sciatic blocks or epidural catheters compared to opioid PCA regarding pain levels, analgesic requirements, and patient satisfaction. However, there was no difference in functional outcome between the 3 groups [229]. …”

Section: Functional Outcomementioning

confidence: 99%

The Role of Continuous Peripheral Nerve Blocks

Aguirre

Moral

Cobo

et al. 2012

Anesthesiology Research and Practice

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A continuous peripheral nerve block (cPNB) is provided in the hospital and ambulatory setting. The most common use of CPNBs is in the peri- and postoperative period but different indications have been described like the treatment of chronic pain such as cancer-induced pain, complex regional pain syndrome or phantom limb pain. The documented benefits strongly depend on the analgesia quality and include decreasing baseline/dynamic pain, reducing additional analgesic requirements, decrease of postoperative joint inflammation and inflammatory markers, sleep disturbances and opioid-related side effects, increase of patient satisfaction and ambulation/functioning improvement, an accelerated resumption of passive joint range-of-motion, reducing time until discharge readiness, decrease in blood loss/blood transfusions, potential reduction of the incidence of postsurgical chronic pain and reduction of costs. Evidence deriving from randomized controlled trials suggests that in some situations there are also prolonged benefits of regional anesthesia after catheter removal in addition to the immediate postoperative effects. Unfortunately, there are only few data demonstrating benefits after catheter removal and the evidence of medium- or long-term improvements in health-related quality of life measures is still lacking. This review will give an overview of the advantages and adverse effects of cPNBs.

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“…On the other hand, performing a post-TKA continuous PCB together with a sciatic nerve block has been reported to be as effective as a continuous epidural nerve block for pain control [18]. The presented study would have had better results if a sciatic nerve block was performed as well.…”

Section: Discussionmentioning

confidence: 83%

“…Watson et al [19] and Raimer et al [18] reported that continuous PCB also resulted in lower pain scores and fewer incidences of side effects such as nausea and sedation when compared to IVPCA. In the present study, the postoperative pain scores 6 hours after surgery between Group IVPCA and Group PCB were not very different.…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous psoas compartment block and intravenous patient controlled analgesia on postoperative pain control after total knee arthroplasty

Lee

Choi

Lee

et al. 2012

Korean J Anesthesiol

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BackgroundTotal knee arthroplasty (TKA) generates severe postoperative pain in 60% of patients and moderate pain in 30% of patients. Because inadequate postoperative pain control can hinder early physiotherapy and rehabilitation, it is the most influential factor dictating a good outcome. The purpose of this study was to evaluate the effectiveness of continuous psoas compartment block (PCB) in comparison to intravenous patient-controlled analgesia (IVPCA) in TKA patients.Methods40 TKA patients were randomly divided into 2 groups. Group IVPCA (n = 20) received intravenous patient controlled analgesia (IVPCA) for 48 hours. Group PCB (n = 20) received continuous PCB for 48 hours at the fourth intertransverse process of the lumbar using the C-arm. Pain scores, side effects, satisfaction, the length of hospital stay, rescue antiemetics, and analgesics were recorded.ResultsPain scores (VNRS 0-100) were higher in Group IVPCA than in Group PCB. Nausea and sedation occurred more frequently in Group IVPCA than in Group PCB. There were no differences between the groups in the length of the hospital stay, satisfaction scores, and the use of rescue antiemetics and analgesics.ConclusionsContinuous PCB seemed to be an appropriate and reliable technique for TKA patients, because it provided better analgesia and fewer side effects such as nausea and sedation when compared to IVPCA.

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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

Cited by 22 publications

References 20 publications

A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

The Role of Continuous Peripheral Nerve Blocks

Effect of continuous psoas compartment block and intravenous patient controlled analgesia on postoperative pain control after total knee arthroplasty

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