Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement

Gerrard, Adam Daniel; Brooks, Ben; Asaad, P; Hajibandeh, Shahab; Hajibandeh, Shahin

doi:10.1007/s00590-016-1846-z

Cited by 31 publications

(31 citation statements)

References 31 publications

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“…Although general or spinal anesthesia is usually selected for ORIF of hip fracture, both methods can cause hypotension in approximately one-third of patients [7]. By contrast, FNB, which has less of an effect on the sympathetic nerves, is expected to impact blood pressure to a lesser extent than spinal anesthesia [8][9][10]. Notably, decreased systemic vascular resistance due to anesthesia is associated with a high risk of an increased pressure gradient across the LVOT, which may create a stronger Venturi effect [4,5,11].…”

Section: Discussionmentioning

confidence: 99%

Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report

et al. 2019

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Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a type of hypertrophic cardiomyopathy associated with left ventricular outflow tract stenosis. The increased pressure gradients across the left ventricular outflow tract in patients with HOCM could lead to circulatory collapse. We describe our experience with perioperative management under femoral nerve block (FNB), lateral femoral cutaneous nerve block (LFCNB), and transthoracic echocardiography (TTE) monitoring during open reduction and internal fixation of a femoral neck fracture in a patient with severe HOCM. Case presentation: A 72-year-old man, who was indicated to undergo open reduction and internal fixation of an intracapsular femoral neck fracture, had a history of treatment for hypertension and HOCM. He had heart failure for 4 years and was hospitalized several times. He was resuscitated after ventricular fibrillation and received an implantable cardioverter-defibrillator at that time. He also had severe physical limitations (New York Heart Association class III). We selected FNB and LFCNB as the methods for anesthesia and injected 0.25% levobupivacaine (20 mL) around the femoral nerve and 0.25% levobupivacaine (10 mL) into the lateral femoral nerve region. He underwent TTE during the perioperative period, which enabled us to perform hemodynamic and morphological evaluations of the heart. The intraoperative TTE findings remained stable from before the induction of anesthesia to the patient's exit from the operating room. Postoperatively, his hemodynamic parameters continued to remain stable. Conclusions: In this case, FNB and LFCNB contributed to hemodynamic stability during non-cardiac surgery. Additionally, TTE was useful for the perioperative evaluation of cardiac hemodynamics and morphology in our patient with severe HOCM.

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Section: Discussionmentioning

confidence: 99%

Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report

et al. 2019

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“…A femoral nerve block has a smaller effect on hemodynamic parameters than spinal-epidural anesthesia. This hemodynamic instability with spinal-epidural anesthesia is mainly induced by the sympathetic block [4–6]. For patients with severe aortic stenosis, it is important to maintain afterload in order to preserve coronary artery blood flow [7].…”

Section: Discussionmentioning

confidence: 99%

Successful use of femoral nerve block with dexmedetomidine for fracture fixation of an intracapsular fracture of the femoral neck in a patient with severe aortic stenosis: a case report

et al. 2017

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We described a case in which femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) with dexmedetomidine (DEX) was useful for open reduction and internal fixation (ORIF) of a femoral neck fracture in a patient with severe aortic stenosis. Cardiac surgery had been recommended but was declined by the patient. Thus, ORIF was selected because of the patient’s concomitant severe aortic stenosis. The anesthesia method used was FNB plus LFCNB with DEX, which achieved adequate local anesthesia. DEX was used to avoid respiratory depression because this patient has pulmonary hypertension. This patient had been sedative up to the end of surgery. Total operating time was 51 min, and the patient’s hemodynamics were stable throughout the perioperative period. There were no complications. In this case, anesthesia using a nerve block with DEX contributed to the safety of noncardiac surgery in a patient with severe cardiac disease under conservative treatment during the perioperative period.

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“…Die Analyse großer Patientenkollektive zeigte die tatsächlichen Risiken bei neuroaxialen Blockaden, insbesondere bei der Anwendung von Epiduralkathetern in bestimmten Patientenkollektiven [21][22][23]. So existiert für die Regionalanästhesie im Rahmen der Knieendoprothetik mit der Blockade peripherer Nerven heute eine im Vergleich zur Epiduralanästhesie gleich wirksame und sichere Alternative [24].…”

Section: Neue Optionen Durch Faszienblockadenunclassified

Regionalanästhesie: traditio et innovatio

Schwemmer

2017

Anaesthesist

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Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement

Cited by 31 publications

References 31 publications

Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report

Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report

Successful use of femoral nerve block with dexmedetomidine for fracture fixation of an intracapsular fracture of the femoral neck in a patient with severe aortic stenosis: a case report

Regionalanästhesie: traditio et innovatio

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