Effects of Postoperative Continuous Femoral Nerve Block Analgesia with Braun Continuous Peripheral Nerve Block Catheter Set versus Novel Needle-Over-Cannula after Total Knee Arthroplasty

Yu, Bin; Hu, Xiaoxue; Zou, Tianxiao; He, Min; Cai, Guangyu

doi:10.12659/msm.893617

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…Compared with the Braun continuous peripheral nerve block catheter set, our cannula-over-needle set is easier to use, is less likely to cause effusion and infection, and is relatively inexpensive; these factors make it ideally suited for use in China. [7] The cannula-over-needle set has been successfully used for continuous brachial plexus block and continuous femoral nerve block. [20,21] In the current investigation also, it proved to be safe and practical.…”

Section: Discussionmentioning

confidence: 99%

“…A modified Ramsay Sedation Scale was used to assess sedation as follows: 0, conscious; 1, occasional hypersomnia but easy to rouse; 2, frequent hypersomnia but easy to rouse; 3, hypersomnia and difficult to rouse. Lower limb motor block was graded using a Bromage score, as follows [7] : 0, nil block-free movement of legs and feet; 1, partial block-able to flex knees with free movement of feet; 2, almost complete block-unable to flex knees, but with free movement of feet; 3, complete block-unable to move legs or feet. Respiratory depression was defined as a respiratory rate <8/minutes.…”

Section: Methodsmentioning

confidence: 99%

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Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Yu¹,

He²,

Cai³

et al. 2016

Medicine

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Background:Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set.Methods:In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block. After ultrasound-guided nerve block, all patients received general anesthesia for surgery and postoperative analgesia through an indwelling cannula. Single-factor analysis of variance was used to compare the outcome variables between the 2 groups.Results:There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6 hours after surgery: 1.0 ± 1.3 in the femoral nerve block group vs 0.5 ± 0.8 in the fascia iliaca compartment block group (P < 0.05). The femoral nerve block group had better postoperative analgesia on the medial aspect of the thigh, whereas the fascia iliaca compartment block group had better analgesia on the lateral aspect of the thigh. There were no other significant differences between the groups.Conclusions:Both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with the novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly hip replacement patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Yu¹,

He²,

Cai³

et al. 2016

Medicine

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“…These characteristics of the CON catheter are considered to be suitable for continuous femoral nerve block. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of catheter-over-needle and catheter-through-needle methods in ultrasound-guided continuous femoral nerve block

et al. 2021

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Background: The catheter-through-needle (CTN) method involves the insertion of a catheter with an outer diameter smaller than the initial puncture hole. We investigated whether the catheter-over-needle (CON) method is more effective than the CTN method in local anesthetic leakage at the catheter insertion site and catheter dislodgement, and how it affects postoperative pain management. Methods: Seventy patients scheduled to undergo continuous femoral nerve block for pain control following total knee arthroplasty were enrolled and randomized to receive a perineural catheterization with either the CTN method (group CTN) or CON method (group CON). After ultrasound-guided catheterization, the transparent securement dressing was attached. The study compared the CON and CTN methods in terms of leakage at the catheter insertion site, catheter dislodgement, and postoperative analgesic efficacy for 48 hours postoperatively. Results: Leakage at the catheter insertion site was significantly lower in the group CON ( P < .05), while catheter dislodgement was not significantly different between the groups. The other adverse events were not different between the groups. The procedure time was significantly shorter in group CON ( P < .05). No significant intergroup differences were observed 48 hours postoperatively in the visual analog scales, the number of patients requiring additional analgesics, and the number of times a bolus dose was injected with an injection pump. Conclusion: The CON method was able to shorten the procedure time while reducing the incidence of leakage at the catheter insertion site than the CTN method, and showed similar effects in postoperative pain management.

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“…If using a different ultrasound-guided insertion technique [ 7 ], such as the short-axis out-of-plane or long-axis in-plane technique, placing the catheter nearly parallel to the target nerve, the effects of patient movement on catheter tip migration and dislocation may differ. Studies involving other CON devices suggest potential benefits to this technology [ 6 23 24 25 ]. To our knowledge, this is the first study to compare CON with more established flexible CTN devices for SAX-IP ultrasound-guided perineural catheter insertion and demonstrate a difference in catheter dislocation.…”

Section: Discussionmentioning

confidence: 99%

Randomized comparison of popliteal-sciatic perineural catheter tip migration and dislocation in a cadaver model using two catheter designs

Steffel

Howard

Borg

et al. 2017

Korean J Anesthesiol

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BackgroundNew catheter-over-needle (CON) technology for continuous peripheral nerve blockade has emerged, but its effect on the risk of perineural catheter tip dislocation is unknown. Less flexible catheters may be more likely to migrate away from the nerve with simulated patient movement. In the present study, we evaluated catheter tip migration between CON catheters and traditional catheter-through-needle (CTN) catheters during ultrasound-guided short-axis in-plane (SAX-IP) insertion.MethodsWe evaluated the migration of popliteal-sciatic catheters in a prone, unembalmed male cadaver. Thirty catheter placement trials were divided randomly into two groups based on the catheter type: CON or CTN. A single anesthesiology resident placed the catheters by SAX-IP insertion, and the catheters were then examined by ultrasound before and after ipsilateral knee range of motion (ROM) exercises (0°–130° flexion). A blinded expert regional anesthesiologist performed caliper measurements on the ultrasound images before and after the ROM exercises. The primary outcome was the change in distance from the catheter tip to the center of the nerve (cm) between before and after the ROM exercises.ResultsThe change in the tip-to-nerve distance (median [10th–90th percentile]) was 0.06 (−0.16 to 0.23) cm for the CTN catheter and 0.00 (−0.12 to 0.69) for the CON catheter (P = 0.663). However, there was a statistically significant increase in dislocation out of the nerve compartment for the CON catheter (4/15; 0/15 for CTN) (P = 0.043).ConclusionsAlthough the use of different catheter designs had no effect on the change in the measured migration distance of popliteal-sciatic catheters, 27% of the CON catheters were dislocated out of the nerve compartment. These results may influence the choice of catheter design when using SAX-IP perineural catheter insertion.

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Effects of Postoperative Continuous Femoral Nerve Block Analgesia with Braun Continuous Peripheral Nerve Block Catheter Set versus Novel Needle-Over-Cannula after Total Knee Arthroplasty

Cited by 7 publications

References 21 publications

Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

Comparison of catheter-over-needle and catheter-through-needle methods in ultrasound-guided continuous femoral nerve block

Randomized comparison of popliteal-sciatic perineural catheter tip migration and dislocation in a cadaver model using two catheter designs

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