Femoral nerve blocks

Nielsen, Karen C.; Klein, Stephen M.; Steele, Susan M.

doi:10.1053/trap.2003.123518

Cited by 13 publications

(6 citation statements)

References 45 publications

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“…† † One method of ensuring excellent femoral anesthesia is the 3-in-1 technique, which blocks the femoral, lateral femoral cutaneous, and obturator nerves. 9 Anesthesiologists can also perform sciatic nerve block when complete anesthesia of the knee is necessary. The femoral nerve alone only provides sensation to the anteromedial aspect of the knee, whereas the sciatic nerve innervates the posterior aspect of the knee.…”

Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

“…Continuous nerve blocks have the advantage of permitting the delivery of analgesia for a longer postoperative duration than single-shot nerve blocks. 9 FNB does not provide a motor blockade to the nonoperative leg, which may encourage earlier ambulation. It also avoids the risk of epidural hematoma that is associated with the use of anticoagulants simultaneously with epidural analgesia.…”

Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

“…FNB groups had significantly less nausea (0.31 Odds) compared with PCA, but there were no differences in terms of pruritus or sedation (see figs. [8][9][10].…”

Section: Opioid Side Effectsmentioning

confidence: 99%

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Femoral Nerve Block Improves Analgesia Outcomes after Total Knee Arthroplasty

et al. 2010

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Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

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Femoral Nerve Block Improves Analgesia Outcomes after Total Knee Arthroplasty

et al. 2010

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“…In several studies, continuous peripheral nerve block showed better results than did the single-shot technique in optimal postoperative pain control after total knee arthroplasty. 14 15 16) Hunt et al 17) also reported that continuous peripheral nerve block yielded results superior to the single-shot technique in terms of pain control after the first 36 hours as well as opioid consumption. Shah et al 16) reported that continuous adductor canal block provided significantly superior results in terms of postoperative pain control than did single adductor canal block, without compromising walking ambulation and early functional recovery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Continuous Femoral Nerve Block and Adductor Canal Block after Primary Total Knee Arthroplasty

et al. 2017

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BackgroundThis study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty.MethodsBetween November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0.75% ropivacaine was administered initially, followed by intermittent bolus injection of 10 mL 0.2% ropivacaine every 6 hours for 3 days). The catheters were maintained in the exact location of nerve block in 24 patients in the femoral nerve block group and in 19 patients in the adductor canal block group. Data collection was carried out from these 43 patients. To evaluate postoperative pain control, the numerical rating scale scores at rest and 45° flexion of the knee were recorded. To evaluate quadriceps strength, manual muscle testing was performed. Walking ability was assessed using the Timed Up and Go test. We also evaluated analgesic consumption and complications of peripheral nerve block.ResultsNo significant intergroup difference was observed in the numerical rating scale scores at rest and 45° flexion of the knee on postoperative days 1, 2, 3, and 7. The adductor canal block group had significantly greater quadriceps strength than did the femoral nerve block group, as assessed by manual muscle testing on postoperative days 1, 2, and 3. The 2 groups showed no difference in walking ability on postoperative day 1, but on postoperative days 2, 3, walking ability was significantly better in the adductor canal block group than in the femoral nerve block group. No significant intergroup difference was observed in analgesic consumption.ConclusionsThe groups showed no difference in postoperative pain control. Adductor canal block was superior to femoral nerve block in preserving quadriceps strength and walking ability. However, adductor canal block was inferior to femoral nerve block in maintaining the exact location of the catheter.

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“…Femoral nerve block (FNB) has been widely used due to its ease of application and its excellent pain relief after TKA [19][20][21][22][23][24][25], while concerned with weakens quadriceps strength [26,27] due to blocking the proximal femoral nerve which contains both motor and sensory fibers [28]. As the alternative, adductor canal block (ACB) can provide equally effective pain relief preserving quadriceps strength [29][30][31][32], because the blocking the nerve distally to that of the FNB can anesthetize only the purely sensory saphenous nerve in the adductor canal [26,27,33].…”

Section: Introductionmentioning

confidence: 99%

Significantly earlier ambulation and reduced risk of near-falls with continuous infusion nerve blocks: a retrospective pilot study of adductor canal block compared to femoral nerve block in total knee arthroplasty

Fujita

Mera

Watanabe

et al. 2022

BMC Musculoskelet Disord

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Background Near-falls should be detected to prevent falls related to the earlier ambulation after Total knee arthroplasty (TKA). The quadriceps weakness with femoral nerve block (FNB) has led to a focus on adductor canal block (ACB). We purposed to examine the risk of falls and the earlier ambulation in each continuous infusion nerve block. Methods Continuous infusion nerve block (FNB or ACB) was performed until postoperative day (POD) 2 or 3. Pain levels and falls/near-falls with knee-buckling were monitored from POD 1 to POD 3. The score on the manual muscle test, MMT (0 to 5, 5 being normal), of the patients who could ambulate on POD 1, was investigated. Results A total of 73 TKA cases, 36 FNB and 37 ACB, met the inclusion criteria. No falls were noted. But episodes of near-falls with knee-buckling were witnessed in 14 (39%) cases in the FNB group and in 4 (11%) in the ACB group (p = 0.0068). In the ACB group, 81.1% of patients could ambulate with parallel bars on POD 1, while only 44.4% of FNB patients could do so (p = 0.0019). The quadriceps MMT values in the ACB group was 2.82, significantly higher than 1.97 in the FNB group (p = 0.0035). There were no significant differences in pain as measured with a numerical rating scale (NRS) and rescue analgesia through POD 3. Conclusion ACB was associated with significantly less knee-buckling and earlier ambulation post-TKA, with better quadriceps strength. Our study indicated the incidence of falls and near-falls with continuous infusion nerve blocks, and support the use of ACB to reduce the risk of falls after TKA. It is suggested that a certain number of the patients even with continuous ACB infusion should be considered with the effect of motor branch to prevent falls.

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Femoral nerve blocks

Cited by 13 publications

References 45 publications

Femoral Nerve Block Improves Analgesia Outcomes after Total Knee Arthroplasty

Femoral Nerve Block Improves Analgesia Outcomes after Total Knee Arthroplasty

Comparison of the Effect of Continuous Femoral Nerve Block and Adductor Canal Block after Primary Total Knee Arthroplasty

Significantly earlier ambulation and reduced risk of near-falls with continuous infusion nerve blocks: a retrospective pilot study of adductor canal block compared to femoral nerve block in total knee arthroplasty

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