The ‘3 in 1’ lumbar plexus block following anterior cruciate ligament reconstruction with autologous hamstring tendons

O’Leary, S.; Unwin, Andrew; Smith, B. L.; Allum, R.

doi:10.1016/s0968-0160(00)00033-8

Cited by 11 publications

(29 citation statements)

References 28 publications

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“…There is concern, however, that RA may provide less effective and reliable pain control. 8 , 13 , 15 , 16 , 18 , 20 Rarely, inadvertent damage to vessels and nerves or injection of the anesthetic intravascularly can result in severe morbidity or mortality. 5 Systemic toxicity can affect the cardiovascular and central nervous systems as described by Edkin et al 5 Inadvertent neural injury can result in prolonged pain, dysesthesias, paresthesias, weakness, and neurapraxia.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies fail to support RA as beneficial. 8 , 13 , 15 , 16 , 18 , 20 Brull et al 3 reviewed the reported complications following femoral nerve block (FNB). All reviewed studies were unblinded and relied on voluntary reporting of complications by the physicians who placed the FNB, either at follow-up or by anonymous phone calls.…”

Section: Discussionmentioning

confidence: 99%

“…Studies evaluating the efficacy of FNB in arthroscopic ACL reconstruction have displayed contradictory results. 8 , 13 , 15 , 16 , 18 , 20 Outcome measures, including patient satisfaction, postoperative pain, use of pain medication postoperatively, and days until discharge, are typically used. In a systematic review of the literature, Mall and Wright 13 evaluated the efficacy of FNB in ACL reconstruction based on level I and II evidence from randomized controlled trials.…”

Section: Discussionmentioning

confidence: 99%

“…Dichotomous results have created controversy with regard to the efficacy of RA in reducing postoperative pain and narcotic requirements. 5 , 8 – 11 , 13 , 15 , 16 , 18 , 20 As a result, variability in regional anesthetic use is common. The purpose of this study was to evaluate the hospital charges and demographic trends in the utilization of general and regional anesthesia for arthroscopic ACL reconstruction.…”

mentioning

confidence: 99%

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Hospital Charges and Practice Patterns for General and Regional Anesthesia in Arthroscopic Anterior Cruciate Ligament Repair

Foster

Terrell

Montgomery

et al. 2013

Orthopaedic Journal of Sports Medicine

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Background:Anesthetic use for arthroscopic anterior cruciate ligament (ACL) reconstruction may display variability in hospital charges and utilization in the United States.Purpose:To evaluate practice patterns and hospital charges for anesthesia in arthroscopic ACL reconstruction.Study Type:Cross-sectional study.Methods:The PearlDiver Patient Records Database, a national database of insurance billing records, was searched using the current procedural terminology (CPT) codes for arthroscopic ACL reconstruction in combination with different types of anesthesia. The search included the years between 2004 and 2009. Age, sex, number of procedures performed, geographic region, and hospital charges for each type of anesthesia were recorded and compared. Anesthetic types were categorized as general anesthesia (GA) only, GA with concomitant single femoral injection, GA with concomitant other regional anesthesia (RA), single femoral injection only, or other RA only.Results:Between 2004 and 2009, a total of 53,968 arthroscopic reconstructive procedures were identified. The mean per patient hospital charge for GA alone, GA in combination with single femoral injection, GA in combination with other RA, single femoral injection alone, and RA alone was $1065 (63% of cases), $1614 (29%), $1849 (4%), $630 (3%), and $612 (1%), respectively. The use of GA in combination with RA or single femoral nerve injection significantly increased during this time period (P = .004 and P < .001, respectively).Conclusion:The mean per patient hospital charges for arthroscopic ACL reconstruction varied with the mode of anesthesia utilized, where regional anesthetic techniques alone were least expensive. RA alone was utilized infrequently, and there was a significant increase in the rate of utilization of GA in combination with any form of RA.Clinical Relevance:This study provides information on current trends and hospital charges for anesthesia in arthroscopic ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Hospital Charges and Practice Patterns for General and Regional Anesthesia in Arthroscopic Anterior Cruciate Ligament Repair

Foster

Terrell

Montgomery

et al. 2013

Orthopaedic Journal of Sports Medicine

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show abstract

“…Intraartikuläre Injektionen von Lokalanästhetika, als "single shot" oder als kontinuierliche Infusion über eine längere Zeit, sind einfach durchzuführen und risikoarm. Aber es ist in der Literatur umstritten, ob die Schmerzkontrolle mit diesen Verfahren ebenso gut gelingt wie mit einer Femoralisblockade [3,8,13,14,15,16,17]. Die divergierenden Ergebnisse in der Literatur dürften zum Teil auf die Unterschiede im Studiendesign, in den angewendeten Lokalanästhetika und -konzentrationen sowie in der Beobachtungdauer nach der Operation zu- Dies zeigt sich auch an den relativ niedrigen NRS-Werten, die wir bei allen Patienten erreichten.…”

Section: Ergebnisseunclassified