Superior perioperative analgesia with combined femoral–obturator–sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery

Bareka, Metaxia; Hantes, Michael; Αrnaoutoglou, Eleni; Vretzakis, George

doi:10.1007/s00167-017-4525-7

Cited by 14 publications

(18 citation statements)

References 39 publications

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“…Contrary to our results, Bareka and his colleagues showed higher VAS scores during tourniquet inflation in PLPS group (when compared with FOS Group) with subsequent more intraoperative fentanyl consumption and this difference was statistically significant [48]. Also, the post-operative pain scores were higher for the PLPS group, and this is additionally reflected in the higher morphine utilization by this group.…”

Section: Discussioncontrasting

confidence: 99%

Combined Sciatic-Lumbar Plexus Block with General Anesthesia: Efficacy in Preventing Tourniquet-Induced Hemodynamic Changes

Mostafa¹

2018

OJAnes

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Background: Pneumatic arterial tourniquet is a utilized strategy in limb surgeries to provide bloodless field to facilitate surgical procedure. Be that as it may, arterial tourniquet has numerous injurious impacts including hemodynamic changes and tourniquet-induced pain which sometimes can be severe and intolerable. Objectives: Our primary aim was to assess the impact of performing "Lumbar Plexus Block and sciatic nerve block" with General Anesthesia (GA) on the degree of arterial tourniquet-induced hemodynamic effects. On the other hand, our secondary aims were: amount of postoperative analgesic prerequisites, patient satisfactory score and documented side effects. Settings and Design: Ain Shams University, Orthopedic operating theatre; a prospective, randomized, double-blind study. Methods and Material: The physical status of 50 patients (both sexes) including I and II patients from American Society of Anesthesiologists, whose ages are from 20-40 years, is not so ideal when they are undergoing elective knee Arthroscopy. The duration lasts no more than ninety minutes under GA with application of tourniquet. Patients were allotted haphazardly to one of two groups. In Group C (Control group): Only GA. In Group B: LPB and sciatic nerve block were performed just before GA administration. Intraoperative hemodynamics was recorded at specific timings. Results: Incidence of tourniquet induced hypertension (TIH) was markedly less with Group B at: forty five, sixty, seventy five mins after tourniquet inflation and just before tourniquet deflation. Also, the total ketorolac consumption during first 24 hours of postoperative period was significantly less with Group B (p < 0.001). Finally, patient satisfaction was significantly higher in Group B. Conclusions: Combined Sciatic-Lumbar plexus blocks when combined with general anesthesia were very effective in attenuating TIH.

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Section: Discussioncontrasting

confidence: 99%

Combined Sciatic-Lumbar Plexus Block with General Anesthesia: Efficacy in Preventing Tourniquet-Induced Hemodynamic Changes

Mostafa¹

2018

OJAnes

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“… 27 – 66 The median (interquartile range) of the sample size for included studies was 60 (40–70) and the Jadad score was 4 (2–5). Articles that did not meet the inclusion criteria upon further evaluation of full text were omitted 67 – 113 and they included incomplete data on analgesic outcomes, 114 – 117 age limit exceeded, 118 – 181 trials involving dental procedures, 182 – 186 and non-translated articles. 187 – 189 The characteristics of the included trials are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Regional anesthesia to ameliorate postoperative analgesia outcomes in pediatric surgical patients: an updated systematic review of randomized controlled trials

Kendall

Alves

Suh

et al. 2018

LRA

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Regional anesthesia is becoming increasingly popular among anesthesiologists in the management of postoperative analgesia following pediatric surgery. The main objective of this review was to systematically evaluate the last 5 years of randomized controlled trials on the role of regional anesthesia techniques in alleviating postoperative pain associated with various pediatric surgical procedures. Forty studies on 2,408 pediatric patients were evaluated. The majority of the articles published from 2013 to 2017 reported that the use of regional anesthesia minimized postoperative pain and reduced opioid consumption. Only a few surgical procedures (cholecystectomy, inguinal hernia repair, and non-laparoscopic major abdominal surgery) reported no significant difference in the postoperative pain relief compared with the standard anesthetic management. The growing number of randomized controlled trials in the pediatric literature is very promising; however, additional confirmation is needed to reinforce the use of specific regional anesthesia techniques to provide optimal postoperative pain relief for a few surgical procedures (reconstructive ear surgery, chest wall deformity, hypospadias, umbilical hernia, cleft palate repair) in pediatric patients. More randomized controlled trials are needed to establish regional anesthesia as an essential component of postoperative analgesia management in children.

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“…For TKA, nerves of lower limbs, including lumbar plexus-sciatic nerve and femoral-sciatic nerve, are mostly blocked. 4 However, the lumbar plexus and sciatic nerve are located deeply, so patients should be kept in the lateral position and suffer from long surgical time even if nerve stimulator or ultrasonic assistance is used. In contrast, since the femoral nerve is located shallowly, patients can take the supine position and nerve stimulator or ultrasound allows rapid localization.…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of single femoral nerve block in combination with general anesthesia on geriatric patients receiving total knee arthroplasty

Yuan¹,

Zhang²,

Wang³

2018

Pak J Med Sci

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Objective:To evaluate the clinical effects of single femoral nerve block (sFNB) combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty (UTKA).Methods:Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway (FLA) group, an sFNB + tracheal intubation (FGA) group and a tracheal intubation (GA) group. Their clinical parameters and indices were recorded. They were scored by the Visual Analogue Scale (VAS).Results:All patients completed this study. FLA and FGA groups used less propofol, remifentanil and fentanyl than GA group (P<0.01), with shorter recovery time and extubation time (P<0.05). Compared to GA group, FLA and FGA groups had lower systolic blood pressures at T3, T4 and T5 (P<0.05), and lower heart rates at T5 (P<0.05). FLA and FGA groups had fewer cases of adverse reactions after extubation (P<0.01). FLA group was less prone to irritating cough after extubation and pharyngeal pain than FGA and GA groups (P<0.01). The postoperative six hour and 24 hour VAS scores in resting state as well as the postoperative 24 hour and 48 hour scores in training state of FLA and FGA groups were lower than those of GA group (P<0.05). FLA and FGA groups used significantly lower times and total doses of patient-controlled intravenous analgesia pump.Conclusion:sFNB combined with general anesthesia, especially that using laryngeal mask, were superior to general anesthesia alone, which reduced recovery and extubation times, and decreased intraoperative and postoperative drug uses, postoperative early VAS score and adverse reactions.

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Superior perioperative analgesia with combined femoral–obturator–sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery

Abstract: I.

Cited by 14 publications

References 39 publications

Combined Sciatic-Lumbar Plexus Block with General Anesthesia: Efficacy in Preventing Tourniquet-Induced Hemodynamic Changes

Combined Sciatic-Lumbar Plexus Block with General Anesthesia: Efficacy in Preventing Tourniquet-Induced Hemodynamic Changes

Regional anesthesia to ameliorate postoperative analgesia outcomes in pediatric surgical patients: an updated systematic review of randomized controlled trials

Clinical effects of single femoral nerve block in combination with general anesthesia on geriatric patients receiving total knee arthroplasty

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