Preoperative Femoral Nerve Block in Hip Arthroscopic Surgery

Dold, Andrew P.; Murnaghan, M. Lucas; Xing, Jerry G.; Abdallah, Faraj W.; Brull, Richard; Whelan, Daniel B.

doi:10.1177/0363546513510392

Cited by 42 publications

(44 citation statements)

References 47 publications

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“…Presented at: 31st Annual European Society of Regional Anaesthesia Congress; 2012) 4,28,37 ; and femoral nerve blocks (FNBs). 12,14,44 While paravertebral blocks and lumbar plexus blocks can anesthetize both the obturator and femoral nerves in a single needle pass, these require considerable technical expertise. Fascia iliaca blocks and FNBs take advantage of the fact that the articular branches of the femoral nerve are the predominant contributors to hip joint innervation.…”

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confidence: 99%

Preoperative Femoral Nerve Block for Hip Arthroscopy

et al. 2015

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Preoperative Femoral Nerve Block for Hip Arthroscopy

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“…Dold et al [20] published a retrospective review of 96 patients, of which 40 received general anesthesia and 56 patients a femoral nerve block preoperatively. A staff anesthesiologist using ultrasound guidance performed all block procedures.…”

Section: Resultsmentioning

confidence: 99%

“…Dold et al [20] reported lower pain scores in the FNB group 60 min after surgery. Total morphine dose in the PACU and maximal pain rating in the surgical day care unit were also significantly lower in the FNB group.…”

Section: Discussionmentioning

confidence: 99%

Perioperative pain management in hip arthroscopy; what options are there?

et al. 2016

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Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed. There are several types of pain regimens that can mostly be divided in two groups: local anesthetics and nerve blocks. Included studies show a rather large variation in reported visual analogue scale scores, post anesthesia care unit admission time and opioid usage. There are several anesthetic options available for hip arthroscopy. Different studies use different dosages, anesthetic regimens and different protocols; this partly explains the differences between studies with similar techniques. Peripheral nerve blocks seems promising but regarding current literature no clear recommendation can be made about what the best perioperative pain management option is, an overview of all reported techniques is given.

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“…Long-term non-arthroplasty-related pain management is mostly unexplored. To our knowledge, despite the notable escalation in surgery rates, only four studies [8–11] have discussed pain medication management strategies for non-arthroplasty orthopedic interventions such as FAI. All involved (acute) peri-operative opioid management only.…”

Section: Introductionmentioning

confidence: 99%

Post-operative opioid pain management patterns for patients who receive hip surgery

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Lewis

et al. 2017

Subst Abuse Treat Prev Policy

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BackgroundIdentifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-operative non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has any study investigated the influence of opioid prescription patterns on health care costs and utilization. We aimed to investigate a subgrouping scheme associated with post-operative opioid prescription strategies and measure the subgroups’ direct and indirect health care utilization and costs in individuals undergoing non-arthroplasty orthopedic hip surgery.MethodsThe study was an observational cohort of routine military clinical practices. We used cluster analysis to characterize pre-operative (12 months) and post-operative (24 months) opioid prescription patterns. Linear mixed effects modeling (with statistical controls for baseline status) identified opioid prescription pattern subgroups and identified subgroup differences in health care utilization and costs.ResultsTwo distinct clusters were identified representing 1) short-duration, high total days’ supply (SD-HD), and 2) long-duration, lesser total days’ supply (LD-LD) post-operative prescription patterns. Significantly higher costs and health care utilization for both hip-related and non-hip-related variables were consistently identified in the SD-HD group.ConclusionsLong-term opioid prescription use has been identified as a concern, but our findings demonstrate that LD-LD post-operative opioid management for hip surgery recipients was associated with lower costs and utilization. Whether these management patterns were a reflection of pre-operative health status, impacted pain-related outcomes, or can be replicated in other orthopedic procedures remains a consideration for future studies.Trial registrationNA.

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Preoperative Femoral Nerve Block in Hip Arthroscopic Surgery

Abstract: A preoperative femoral nerve block is a relatively safe procedure that may decrease the requirement for intraoperative morphine while providing effective postoperative pain control in patients undergoing hip arthroscopic surgery.

Cited by 42 publications

References 47 publications

Preoperative Femoral Nerve Block for Hip Arthroscopy

Preoperative Femoral Nerve Block for Hip Arthroscopy

Perioperative pain management in hip arthroscopy; what options are there?

Post-operative opioid pain management patterns for patients who receive hip surgery

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