Lidocaine Plus Ropivacaine Versus Lidocaine Plus Bupivacaine for Peribulbar Anesthesia by Single Medial Injection

Gillart, Thierry; Barrau, Philippe; Bazin, J. E.; Roché, G; Chiambaretta, Frédéric; Schoeffler, P.

doi:10.1097/00000539-199911000-00020

Cited by 21 publications

(26 citation statements)

References 7 publications

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“…However, different catheter insertion techniques, different anatomic locations, variations in equipment and different infusion regimens make comparisons difficult. In fact, several prospective studies report an incidence of secondary block (during infusion) failure of 1% [253], 20% [197], and 50% [254]. Therefore, all reported complications in this chapter cannot be translated to the different clinical practices.…”

Section: Adverse Effectsmentioning

confidence: 97%

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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Section: Adverse Effectsmentioning

confidence: 97%

The Role of Continuous Peripheral Nerve Blocks

Aguirre

Moral

Cobo

et al. 2012

Anesthesiology Research and Practice

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“…However, it has been noted in our department that patients require more pain relief in the posterior side of their operated knees than the anterior side as the posterior part of the knee is innervated by the sciatic nerve and its branches [Figure 1]. Osteotomy segments of the knee are also innervated by the sciatic nerve from the S1 root 2. While a sciatic block is a solution to this problem, it is a technically demanding procedure that requires considerable patient cooperation to achieve the best position for surgery 10.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to the extreme tissue dissection involved, TKA is often cited as one of the most painful known procedures 123. Approximately, 20% of patients with osteoarthritis of the knee do not want to undergo TKA because of the expectancy of high levels of pain 2. After knee surgery, the pain may also inhibit early rehabilitation to mobilize the knee joint 1.…”

Section: Introductionmentioning

confidence: 99%

Pain management in total knee arthroplasty by intraoperative local anesthetic application and one-shot femoral block

Sigirci

2017

IJOO

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Background:Pain after total knee arthroplasty (TKA) is a big problem in orthopaedic surgery. Although opioids and continuous epidural analgesia remain the major options for the postoperative pain management of TKA, they have some undesirable side effects. Epidural analgesia is technically demanding, and the patient requires close monitoring. Different types of local anesthetic applications can successfully treat TKA pain. Local anesthetics have the advantage of minimizing pain at the source. This study investigates the efficacy of different local anesthetic application methods on early, (1st day) pain control after total knee arthroplasty.Materials and Methods:200 patients who underwent unilateral TKA surgery under spinal anesthesia were randomly assigned into four different groups (fifty in each group) and were administered pain control by different peri- and postoperative regimens. Group A was the control group wherein no postsurgical analgesia was administered to assess spinal anesthesia efficacy; in Group B, only postsurgical one-shot femoral block was applied; in Group C, intraoperative periarticular local anesthetic was applied; in Group D, a combination of the one-shot femoral block and intraoperative periarticular local anesthetics were applied. Demographic data consisting of age, weight, gender and type of deformity of patients were collected. The data did not differ significantly between the four groups.Results:Group D patients experienced significantly better postoperative pain relief (P < 0.05) and were therefore more relaxed in pain (painless time, VAS score) and knee flexion (degrees) than the other patient groups in the 1st postoperative day followup. Painless time of Group D was 10.5 hours and was better than Group C (6.8 hours), Group B (6.2 hours) and Group A (3.0 hours) (P < 0.05). Group A got the best pain Vas score degrees in the 1st postoperative day which showed the success of combined periarticülar local anesthetic injection and femoral nerve block.Conclusion:The intraoperative periarticular application of local anesthetics in addition to one-shot femoral block is an efficient way of controlling postsurgical pain after TKA.

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“…In addition postoperative femoral block was shown to reduce the length of stay in the surgical ward and improve the post-operative rehabilitation process [5]. Prolonged opioid sparing after total knee arthroplasty was supposed to be the result of preemptive analgesic effects of peripheral nerve blocks performed under spinal anesthesia [2, 10]. However, clear clinical evidence for preemptive analgesia has yet to be established, despite what appears to be convincing experimental evidence.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pre-Incisional Continuous Regional Block on Early and Late Postoperative Conditions in Tibial Osteotomy and Total Knee Arthroplasty

Motamed

Combes²,

Ndoko³

et al. 2009

TOORTHJ

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Background:Postoperative regional anesthesia hastens recovery and reduces the length of hospital stay of orthopedic surgical patients. This study was designed to assess the impact of pre-incisional continuous femoral block on postoperative conditions (POC) of tibial osteotomy and total knee arthroplasty patients.Methods:After insertion of a femoral catheter under peripheral nerve stimulation control, 111 patients scheduled for total knee arthroplasty or tibial osteotomy were randomized to receive either pre-incisionnal (treatment) or postoperative (control) continuous femoral block. Anesthesia and postoperative management was standardized. An assessor blinded to the randomization process recorded early and late postoperative conditions (POC) which included pain scores, opioid demands, length of stay in Postoperative care unit and patients’ satisfaction.Results:Eleven patients were excluded from the final analysis because of catheter disconnection or malfunction. Thus 100 patients (50 in each group) were analyzed for POC. Treatment failed to influence patients overall satisfaction but significantly improved early POC. Subgroup analysis demonstrated that late POC were significantly improved in tibial osteotomy as compared to total knee arthroplasty patients. No complication occurred during the study period.Conclusion:Continuous femoral nerve block before surgery significantly improved early postoperative conditions in both surgery while late postoperative conditions were improved only in tibial osteotomy.

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Lidocaine Plus Ropivacaine Versus Lidocaine Plus Bupivacaine for Peribulbar Anesthesia by Single Medial Injection

Cited by 21 publications

References 7 publications

The Role of Continuous Peripheral Nerve Blocks

The Role of Continuous Peripheral Nerve Blocks

Pain management in total knee arthroplasty by intraoperative local anesthetic application and one-shot femoral block

Effect of Pre-Incisional Continuous Regional Block on Early and Late Postoperative Conditions in Tibial Osteotomy and Total Knee Arthroplasty

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