Equivalence of postoperative quadriceps strength during 1 or 0.5 mg ml−1 levobupivacaine administration for continuous femoral nerve block following total knee arthroplasty

Sakai, Norihiro; Nakatsuka, Miho; Tomita, Tadanori; Inoue, T

doi:10.1097/eja.0000000000000230

“…Diversas alternativas se han implementado para prevenir una paresia excesiva del cuádriceps, siendo algunas enfocadas en un bloqueo anatómicamente más selectivo y distal de ramos del nervio femoral (NF) [5]- [11] o a una infiltración de anestésicos locales (AL) directamente a nivel periarticular [12], mientras que algunas han intentado optimizar el BCNF [13]- [18]. Entre estas últimas, se ha evaluado el uso de diferentes volúmenes y concentraciones de AL, comparando infusiones continuas con bolos intermitentes, con y sin dosis de demanda, sin encontrar mayores beneficios en términos de preservación de fuerza [14], [15].…”

unclassified

Cirugía de hombro en posición silla de playa: estrategias y recomendaciones para la prevención de complicaciones isquémicas

Espinoza¹,

Bollini²

2020

Rev. chil. anest.

1

0

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Introduction:The commonly used concentrations of local anesthetics (LA) for femoral nerve block (FNB) cause a significant decrease in the quadriceps strength (QS), limiting physiotherapy and determining a risk factor for patient's falls. The use of more dilute solutions could determine the preservation of motor function without impairing analgesia. methods: Five patients scheduled for total knee arthroplasty (TKA) received a preoperative FNB with 20 mL of bupivacaine in decreasing concentrations (0.0875%, 0.075%, 0.0625%, 0.050%, 0.0375%). Sensory block to cold in the anterior knee region, QS, surface electromyography (SEMG) of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) plus were recorded before and 30 minutes after the blockage. Posteriorly, the clinical data of 20 patients who underwent TKA and received a continuous femoral nerve block (CFNB) with bupivacaine in the most dilute concentration that granted sensory blockade and significantly preserved the QS in the previous analysis were retrospectively analyzed. Postoperative pain at 24 and 48 hours, morphine consumption at 24 hours, the ability to successfully perform physiotherapy on the first postoperative day (POD) and reports of falls were rescued from the patients' files. Finally, seventy-five patients that underwent TKA during 2018 who received a CFNB with a similar dilution, but using levobupivacaine, were also retrospectively analyzed. Postoperative pain, need for advanced rescue analgesia, ability to perform physiotherapy, CFNB related complications and reports of patients falls during the first 72 hours post-

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“…Diversas alternativas se han implementado para prevenir una paresia excesiva del cuádriceps, siendo algunas enfocadas en un bloqueo anatómicamente más selectivo y distal de ramos del nervio femoral (NF) [5]- [11] o a una infiltración de anestésicos locales (AL) directamente a nivel periarticular [12], mientras que algunas han intentado optimizar el BCNF [13]- [18]. Entre estas últimas, se ha evaluado el uso de diferentes volúmenes y concentraciones de AL, comparando infusiones continuas con bolos intermitentes, con y sin dosis de demanda, sin encontrar mayores beneficios en términos de preservación de fuerza [14], [15].…”

unclassified

Concentración de bupivacaína y preservación de fuerza de cuádriceps en bloqueo femoral para artroplastía total de rodilla

Bravo¹,

Layera²,

Cristi³

et al. 2020

Rev. chil. anest.

0

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Introduction:The commonly used concentrations of local anesthetics (LA) for femoral nerve block (FNB) cause a significant decrease in the quadriceps strength (QS), limiting physiotherapy and determining a risk factor for patient's falls. The use of more dilute solutions could determine the preservation of motor function without impairing analgesia. methods: Five patients scheduled for total knee arthroplasty (TKA) received a preoperative FNB with 20 mL of bupivacaine in decreasing concentrations (0.0875%, 0.075%, 0.0625%, 0.050%, 0.0375%). Sensory block to cold in the anterior knee region, QS, surface electromyography (SEMG) of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) plus were recorded before and 30 minutes after the blockage. Posteriorly, the clinical data of 20 patients who underwent TKA and received a continuous femoral nerve block (CFNB) with bupivacaine in the most dilute concentration that granted sensory blockade and significantly preserved the QS in the previous analysis were retrospectively analyzed. Postoperative pain at 24 and 48 hours, morphine consumption at 24 hours, the ability to successfully perform physiotherapy on the first postoperative day (POD) and reports of falls were rescued from the patients' files. Finally, seventy-five patients that underwent TKA during 2018 who received a CFNB with a similar dilution, but using levobupivacaine, were also retrospectively analyzed. Postoperative pain, need for advanced rescue analgesia, ability to perform physiotherapy, CFNB related complications and reports of patients falls during the first 72 hours post-

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Perioperative Pain Management

Tsukada

2024

Advances in Total Knee Arthroplasty

0

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Equivalence of postoperative quadriceps strength during 1 or 0.5 mg ml−1 levobupivacaine administration for continuous femoral nerve block following total knee arthroplasty

Cited by 3 publications

References 7 publications

Cirugía de hombro en posición silla de playa: estrategias y recomendaciones para la prevención de complicaciones isquémicas

Cirugía de hombro en posición silla de playa: estrategias y recomendaciones para la prevención de complicaciones isquémicas

Concentración de bupivacaína y preservación de fuerza de cuádriceps en bloqueo femoral para artroplastía total de rodilla

Perioperative Pain Management

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