Femoral nerve block as an alternative to parenteral narcotics for pain control after anterior cruciate ligament reconstruction

Edkin, Brian S.; Spindler, Kurt P.; Flanagan, John F.

doi:10.1016/0749-8063(95)90191-4

Cited by 80 publications

(57 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As observações deste estudo apresentam boa relação risco/benefício entre as técni-cas de anestesia locorregional, superior à morfina subaracnóidea para analgesia pós-operatória em pacientes submetidos aos procedimentos realizados neste estudo. A necessidade de analgésico no pós-operatório foi de 60% no grupo BPL e 75% no grupo M, diferentemente do estudo de Edkin e col. 57 em que 92% do pacientes não necessitaram de analgésicos nas primeiras 24 horas do pós-operatório. Esta diferença provavelmente foi devida ao fato de que a administração do analgésico utilizado no pós-operatório foi baseada na EAV, adotando-se a administração sempre que a escala mostrava-se igual ou superior a 4, visando o conforto do paciente, e não por solicitação espontânea do paciente.…”

Section: Discussionunclassified

Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina

Fonseca¹,

Ruzi²,

Ferreira³

et al. 2003

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

show abstract

Section: Discussionunclassified

Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina

Fonseca¹,

Ruzi²,

Ferreira³

et al. 2003

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

show abstract

“…The results showed that of the 24 patients who received the nerve block, 92% did not take any parenteral narcotic. 14 The study showed significant reductions in the patients' narcotic requirements and an equally significant extension of the time between incision and the patients' initial narcotic dose.…”

Section: Peripheral Nerve Blockade and Narcotic Consump-tionmentioning

confidence: 91%

“…Likewise, Bingham et al 7 also showed that, when coupled with rehabilitation, CPNBs facilitate early hospital discharge. In another study, Edkin et al 14 showed that the use of CPNBs facilitates same-day discharge for several surgery types that would normally require overnight admission for pain control. The average time of hospitalization was significantly decreased for patients using femoral nerve blocks as a means of analgesia, instead of morphine PCA.…”

Section: Pagementioning

confidence: 99%

See 1 more Smart Citation

Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

Kerfeld¹,

Hambsch²,

McEntire³

et al. 2016

Anesthesiol Open J

View full text Add to dashboard Cite

Review ABSTRACTPeripheral nerve blockade is an effective modality involved in controlling perioperative pain. When compared with patient controlled analgesia, neuraxial analgesia, and other anesthetic methods such as periarticular infiltration, peripheral nerve blocks yield superior pain control and reduce length of hospitalization. Not only do these techniques help with patient satisfaction and health care costs, they also have physiologic advantages. In murine models, peripheral nerve blockade reduces expression of different inflammatory markers such as IL-1, IL-6, TNFα and cortisol. Such advantages make this an attractive modality for pain control.

show abstract

“…Unfortunately, pain relief with opioids is often unsatisfactory, 1-3 may cause pain upon intra-articular injection, 4 and can lead to a delay in recovery and hospital discharge due to associated adverse events. Regional nerve blocks, such as femoral nerve blockade, have been employed with some success; 5,6 however, there is an inherent risk of neuropraxia and conflicting data regarding efficacy. 7 Both pre-surgical 8,9 and post-surgical 10 local anesthetic (LA) infiltration have been shown to be effective in reducing postoperative analgesic requirements with minimal side effects.…”

mentioning

confidence: 99%

Combined pre- and post-surgical bupivacaine would infiltrations decrease opioid requirements after knee ligament reconstruction

Butterfield

Schwarz

Ries

et al. 2001

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

GENERAL ANESTHESIA 245Purpose: To test the efficacy of a combination of selective pre-and post-surgical local anesthetic infiltrations of the knee, compared with standard intra-articular injection at the end of surgery alone, to reduce postoperative opioid requirements following arthroscopic cruciate ligament reconstruction (ACLR). Methods: In a double-blind, randomized, controlled trial, we studied 23 patients (ASA I or II) scheduled for elective ACLR under general anesthesia. The treatment group (n=12) received infiltrations with bupivacaine 0.25% with epinephrine 1:200 000 presurgically (10 ml into the portals, 10 ml at the medial tibial incision site, 10 ml at the lateral femoral incision site, and 10 ml intra-articularly) and postsurgically (5 ml at the medial tibial incision and 10 ml at the lateral femoral incision). The control group (n=11) received infiltrations with saline 0.9% in the same manner. All patients received a standard intra-articular local anesthetic instillation of the knee (25 ml of bupivacaine 0.25% with epinephrine 1:200 000) at the completion of surgery. Results: Postoperative opioid requirements were lower in the treatment group (5.8 ± 2.9 mg morphine equivalent) than in the control group (13.7 ± 5.8 mg; P=0.008). Treatment patients were ready for discharge approximately 30 min earlier than control patients (P=0.046). There were no adverse events in the treatment group. In the control group, 2/11 patients vomited and a third experienced transient postoperative diaphoresis, dizziness and pallor. Conclusion: We conclude that a combination of selective pre-and post-surgical wound infiltration with bupivacaine 0.25% provides superior analgesia compared with a standard post-surgical intra-articular injection alone.Objectif : Tester l'efficacité d'une combinaison d'infiltrations sélectives du genou, préopératoires et postopéra-toires, avec un anesthésique local, comparée à l'injection intra-articulaire régulière de fin d'intervention seulement, dans le but de réduire les besoins postopératoires d'opioïdes à la suite de la reconstruction arthroscopique du ligament croisé (RALC). Méthode : L'étude randomisée, contrôlée et à double insu a porté sur 23 patients (ASA I ou II) pour qui une RALC avait été prévue sous anesthésie générale. Les patients étudiés (n = 12) ont reçu des infiltrations préchirur-gicales de bupivacaïne à 0,25 % avec de l'épinéphrine à 1:200 000 (10 ml via le portail, 10 ml au site d'incision tibial médian, 10 ml dans l'incision fémorale latérale et 10 ml intra-articulaire) et postchirurgicales (5 ml dans l'incision tibiale médiane et 10 ml dans l'incision fémorale latérale). Les patients témoins (n = 11) ont reçu des infiltrations de solution salée à 0,9 %, administrées de la même manière. Tous les patients ont reçu une instillation anesthésique standard locale dans l'articulation du genou (25 ml de bupivacaïne à 0,25 % avec de l'épinéphrine à 1:200 000) à la fin de l'opération. Résultats : Les patients testés ont demandé moins d'opioïdes postopératoires (5,8 ± 2,9 mg d'équ...

show abstract

Femoral nerve block as an alternative to parenteral narcotics for pain control after anterior cruciate ligament reconstruction

Cited by 80 publications

References 24 publications

Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina

Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina

Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

Combined pre- and post-surgical bupivacaine would infiltrations decrease opioid requirements after knee ligament reconstruction

Contact Info

Product

Resources

About