scholarly journals Effectiveness of Ultrasonography Guided Femoral Nerve Block for Patient Positioning during Central Neuraxial Block in Elderly Patients for Fracture of Femur - A Prospective, Randomized Control Trial

2021 ◽  
Vol 10 (31) ◽  
pp. 2390-2395
Author(s):  
Ratindra Kumar Barman ◽  
Karamchand Basumatary ◽  
Ananta Hazarika
Keyword(s):  
Elderly Patients ◽  
Nerve Block ◽  
Spinal Anaesthesia ◽  
Randomized Control Trial ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Control Group ◽  
Total Consumption ◽  
Fracture Femur ◽  
Randomized Control

BACKGROUND Central neuraxial blocks, mainly spinal anaesthesia is the preferred anaesthesia over general anaesthesia in fracture of femur surgeries in elderly patients because of various side effects associated with general anaesthesia. However, the majority of the patients during positioning for spinal anaesthesia are associated with severe pain for which positioning becomes difficult. We wanted to assess the effectiveness of ultrasound (USG) guided femoral nerve block (FNB) to reduce pain during the positioning for spinal anaesthesia in fracture femur patients. METHODS It was a randomized control trial conducted on 80 elderly ASA I, II and III patients (45 - 70 years) posted for various femur surgeries under spinal anaesthesia having visual analogue scale (VAS) ≥ 4 during positioning. Patients in group FNB (N = 40) received USG guided femoral nerve block with 0.2 % ropivacaine and in control group (N = 40) didn’t receive any interventions preoperatively. All patients received injection fentanyl during positioning if VAS ≥ 4. Parameters recorded included VAS at baseline, 15 mins and during positioning, anaesthesiologist’s satisfaction (yes or no), total fentanyl consumption and patient’s satisfaction (Likert scale). RESULTS Demographic variables were comparable to each group. VAS in FNB at 15 mins and during positioning was 2.3 ± 1.042 and 3.025 ± 0.831 in comparison to 6.125 ± 0.607 and 7.2 ± 0.822 in control group respectively. Only 5 patients required injection fentanyl and total consumption was 142 ± 3.21 µg in FNB group while all patients in control group required injection fentanyl and total consumption was 1162 ± 4.43 µg. Anaesthesiologists and patients satisfaction were much higher in FNB group. CONCLUSIONS USG - guided FNB is very effective in controlling pain during positioning for spinal anaesthesia in fracture femur patients. KEY WORDS Ultrasound, Femoral Nerve Block, Spinal Anaesthesia, Ropivacaine, Fracture Femur

USG Guided Femoral Nerve Block for Fracture Femur to Make the Patient Sit Comfortably for Spinal Anaesthesia

2017 ◽  
Vol 4 (3 (part-1)) ◽  
pp. 664-668
Author(s):  
R. Padmaja ◽  
◽  
G.T.S. Kranthi Kumar ◽  
P. Narasimha Reddy ◽  
◽  
...  
Keyword(s):  
Nerve Block ◽  
Spinal Anaesthesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Fracture Femur

scholarly journals Ultrasound-Guided Continuous Femoral Nerve Block with Dexmedetomidine Combined with Low Concentrations of Ropivacaine for Postoperative Analgesia in Elderly Knee Arthroplasty

2019 ◽  
Vol 28 (5) ◽  
pp. 457-462 ◽  
Author(s):  
Xiao-Ying Zhao ◽  
Er-Fei Zhang ◽  
Xiao-Li Bai ◽  
Zi-Jian Cheng ◽  
Peng-Yun Jia ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Low Concentrations ◽  
Functional Exercise ◽  
Continuous Femoral Nerve Block

Objectives: This study aims to investigate the clinical effect of dexmedetomidine (DEX) combined with low concentrations of ropivacaine in ultrasound-guided continuous fem­oral nerve block for postoperative analgesia in elderly patients with total knee arthroplasty (TKA). Materials and Methods: Patients were divided into three groups: group C, group D1, and group D2. For postoperative analgesia, patients in group C were given 0.15% ropivacaine, patients in group D1 were given 0.15% ropivacaine + 0.02 μg × kg–1 × h–1 DEX, and patients in group D2 were given 0.15% ropivacaine + 0.05 μg × kg–1 × h–1 DEX. The visual analogue scores in the resting state, active state (AVAS), and passive functional exercise state (PVAS), degree of joint bending, and Ramsay scores were recorded. Results: The Ramsay scores were significantly higher, AVAS scores were significantly lower, PVAS scores were significantly decreased, the degree of joint bending was significantly higher, and the time to the first postoperative ambulation was shorter in groups D1 and D2 than group C. Furthermore, the time to the first postoperative ambulation was shorter in group D2 than in group D1, patients in groups D1 and D2 were more satisfied than patients in group C, and patients in group D2 were more satisfied than patients in group D1. Conclusion: The protocol of 0.05 μg × kg–1 × h–1 of DEX combined with 0.15% ro­pivacaine in ultrasound-guided continuous femoral nerve block for postoperative analgesia in elderly patients with TKA provides a better analgesic effect than without DEX performance.

scholarly journals Effect of Ketoprofenphonophoresis and Femoral Nerve Block in Knee Osteoarthritis

2021 ◽  
Vol 5 (6) ◽  
pp. 72-78
Author(s):  
Fan Fan ◽  
Wei Wei ◽  
Binyan He ◽  
Chaonan Li ◽  
Qing Yang ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Combined Treatment ◽  
Femoral Nerve ◽  
Control Group ◽  
Before And After ◽  
Effective Efficiency ◽  
Experimental Group

Objective: To evaluate the effect of ketoprofenphonophoresis and femoral nerve block in knee osteoarthritis. Methods: One hundred and fourteen patients with knee osteoarthritis were randomly divided into two groups. The control group consisted of 57 patients who were treated with only ketoprofenphonophoresis. The experimental group consisted of patients were treated with ketoprofenphonophoresis and femoral nerve block. The patients were followed for more than one month. The treatment effect assessed by observing their WOMAC index before and after therapy. Results: All the patients finished the follow-up. Their WOMAC indexes were reduced after therapy and one month after treatment, especially in the experimental group (P < 0.05). The effective efficiency of ketoprofenphonophoresis and femoral nerve block were higher than that in the control group after treatment and after one month of follow-up (P < 0.05). Conclusion: Compared with only ketoprofenphonophoresis, the combined treatment of ketoprofenphonophoresis and femoral nerve block was more appropriate in knee osteoarthritis.

scholarly journals Effect of periarticular multimodal injection versus femoral nerve block on in-hospital rehabilitation after total knee arthroplasty in Chinese population: A prospective randomized control trial study

2020 ◽  
Vol 27 (2) ◽  
pp. 214-220
Author(s):  
Ip Hoi Yeung ◽  
Yeung Yip Kan ◽  
Lo Kim Cheong ◽  
Tse Choi Yeung Andy ◽  
Wong Kwok Ho
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Control ◽  
Randomized Control Trial ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Length Of Hospital Stay ◽  
Knee Score ◽  
Prospective Randomized Control Trial ◽  
Total Knee ◽  
Randomized Control

Introduction: Total knee arthroplasty has been adopted to be the most successful treatment for advanced knee osteoarthritis. The adoption of multimodal periarticular analgesic (MPI) has been shown to have satisfactory pain control after surgery. However, there is relatively lack of data investigating whether this mode of pain control is effective in enhancing rehabilitation. Method: This is a prospective randomized control trial from July 2017 to June 2018, including 82 patients, in which 43 of them had MPI injection and 39 of them had no MPI injection. Primary outcome measures included the number of days required to perform straight leg raise, length of hospital stay, and Insall knee score upon discharge. Secondary outcome measures included total dose of patient-controlled analgesia (PCA) consumption postoperatively and visual analog scale (VAS) at rest and on motion during postoperative days 1–4. Result: The MPI group performed significantly better than the femoral nerve block (FNB) group in terms of early functional outcome, namely the number of days required to perform straight leg raising and length of hospital stay. The total postoperative PCA consumption and VAS score on motion during postoperative day 1 were also significantly better for MPI group. There was no difference in Insall knee score upon discharge between these two groups. Conclusion: Compared to FNB, MPI depicts a faster inpatient rehabilitation, accounted by its quadriceps-sparing, and better pain relief especially in the early postoperative period.

scholarly journals Positioning of fracture femur patients for spinal anesthesia: Femoral nerve block or intravenous fentanyl?

2018 ◽  
Vol 2 (3) ◽  
pp. 61 ◽  
Author(s):  
Chandni Sinha ◽  
Amarjeet Kumar ◽  
Ajeet Kumar ◽  
Poonam Kumari ◽  
Ditipriya Bhar ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Intravenous Fentanyl ◽  
Fracture Femur

Spinal anaesthesia or sciatic-femoral nerve block for outpatient knee arthroscopy

2000 ◽  
Vol 17 (Supplement 19) ◽  
pp. 112
Author(s):  
G. Cappelleri ◽  
D. Anelati ◽  
A. Casati ◽  
P. Beccaria ◽  
M. Berti ◽  
...  
Keyword(s):  
Nerve Block ◽  
Spinal Anaesthesia ◽  
Knee Arthroscopy ◽  
Femoral Nerve Block ◽  
Femoral Nerve
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