scholarly journals Comparison of Combined Femoral Nerve Block and Spinal Anesthesia With Lumbar Plexus Block for Postoperative Analgesia in Intertrochanteric Fracture Surgery

2012 ◽  
Vol 2 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Hamid Reza Amiri ◽  
Saeid Safari ◽  
Jalil Makarem ◽  
Mojgan Rahimi ◽  
Behnaz Jahanshahi
Keyword(s):  
Spinal Anesthesia ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Intertrochanteric Fracture ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lumbar Plexus ◽  
Lumbar Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

scholarly journals The Comparing of Ultrasound-guided Techniques: Sciatic Block with Continuous Lumbar Plexus Block or Continuous Femoral Nerve Block for Anesthesia and Analgesia of Total knee Replacement

2013 ◽  
Vol 7 (1) ◽  
pp. 19-25
Author(s):  
M. Dauri ◽  
S. Faria ◽  
L. Celidonio ◽  
P. David ◽  
A. Bianco ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lumbar Plexus ◽  
Ultrasound Guided ◽  
Lumbar Plexus Block ◽  
Total Knee ◽  
Plexus Block

Background and Aims: This double blind prospective randomized clinical trial evaluated the efficacy and safety of continuous ultrasound-guided lumbar plexus block compared to continuous ultrasound-guided femoral nerve block, in the intra-operative and postoperative periods after total knee replacement. Methods: Forty ASA I-III patients were randomized to receive: continuous femoral block (n= 20, 30 ml of ropivacaine 5 mg/ml) or continuous lumbar plexus block (n= 20, 30 ml of ropivacaine 5 mg/ml) both in association with single injection sciatic nerve block. All patients received continuous infusion of 2 mg/ml of ropivacaine at 8 ml/h for 48 hours and intravenous morphine for patient-controlled analgesia. Primary outcomes were intra-operative sufentanil consumption and verbal analogue scale (VAS) score at rest at 24h follow up. Results: Intra-operative sufentanil consumption was higher in the femoral block (FEM) group compared to the lumbar plexus block (PSOAS) group (FEM: 10.00 (10.00, 17.50) µg; PSOAS: 2.50 (0.00, 10.00) µg. p= 0.002). Obturator motor blockade occurred more frequently in the PSOAS group (70%) than in the FEM group (40%) (p=0.1); however, we found no differences in sensory blockade (p=0.6). VAS at rest was similar in the two groups at 24h postoperatively (FEM: 29.50 ± 14.74 mm; PSOAS: 25.60 ±17.42 mm. p=0.4), and throughout the follow-up period. No differences were detected in pain scores during physiotherapy. Conclusion: Continuous femoral and lumbar plexus blocks, both in association with sciatic nerve block, provided similar VAS scores at 24h, and throughout the follow-up period; intra-operative sufentanil consumption was, however, lower in the lumbar plexus block group.

scholarly journals Ultrasound Guided Femoral Nerve Block with Bupivacaine versus Bupivacaine and Tramadol for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty under Spinal Anesthesia

2021 ◽  
pp. 23-32
Author(s):  
Mohammad Mostafa Abo Farrag ◽  
Laila Elahwal ◽  
Hesham Mohammad Maroof ElDomairy ◽  
Mohammad Ibrahem Okab
Keyword(s):  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Group I ◽  
Total Knee

Background: Effective pain control in Total knee arthroplasty (TKA) is important for optimizing the rehabilitation process in order to achieve patient satisfaction with a good functional outcome as well as reduce hospitalization duration and costs. Combined use of aesthetic with tramadol has been reported to achieve a longer duration of sensory and motor block. The aim of this study is to evaluate the quality and duration of postoperative analgesia produced by ultrasound guided femoral nerve block (FNB) by bupivacaine versus (bupivacaine & tramadol) in patients undergoing total knee arthroplasty under spinal anesthesia. Methods: This prospective randomized controlled double blinded study was carried out on 60 patients aged above 50 years; American Society of Anesthesiologists physical status (ASA) I-III scheduled for total knee arthroplasty under spinal anesthesia. Patients were randomized to one of two equal groups: Group I control (C): received FNB with 30 ml 0.25% bupivacaine. Group II tramadol (T): received FNB with 30ml 0.25% bupivacaine and 100 mg tramadol. Results: Postoperative heart rate was significantly increased in group C than group T at 8h, 12h, 16h and 24h. Postoperative mean arterial blood pressure was significantly increased in group C than group T at 6h, 8h, 12h, 16h and 24h. There were 30 (100%) patients required rescue analgesia in group C and 19 (63.33%) patients in group T which was increased significantly in group C than group T. The time to first analgesic requirement was significantly decreased in group C than group T. Total morphine consumption was increased significantly in group C than group T. VAS was increased significantly in group C than group T at 6, 8, 12, 16 and 24 hours. Adverse effects were insignificantly different between both groups. Conclusion: Adding tramadol (100 mg) to 0.25% bupivacaine (to a volume of 30 ml) during US guided FNB of TKA under spinal anesthesia was associated with better postoperative analgesia when compared with 0.25% bupivacaine alone.

scholarly journals Comparative Study between Spinal Anesthesia and Lumbar Plexus Block for Intraoperative Anesthesia and Postoperative Analgesia in Fracture Femur Surgery

2020 ◽  
pp. 75-84
Author(s):  
Mohamed G. Naeem ◽  
Naglaa K. Mohammed ◽  
Reda S. Abd Elrahman ◽  
Osama M. Shalaby
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Lumbar Plexus ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Fracture Femur ◽  
Group I ◽  
Lumbar Plexus Block ◽  
Plexus Block

Background: Fracture femur is common in elderly. Spinal anesthesia (SA) in elderly patients can be associated with major hemodynamic changes whereas lumbar plexus block (LPB) can provide ideal perioperative analgesia as there is no hemodynamic instability or depression of pulmonary functions. The purpose of this study is to compare the efficacy of SA versus LPB for intraoperative anesthesia and postoperative analgesia in fracture femur surgery. Materials and Methods: This prospective randomized controlled study was carried out 70 patients of either sex with age >20 years, ASA physical status I - III scheduled for fracture femur surgery. Patients were randomly classified into two equal groups (n = 35); group I (SA) received SA by heavy bupivacaine HCL 0.5% 2.5-3.5 ml and group II (LBP) received posterior LPB by 30-35 ml bupivacaine 0.5%. Results: The time for performing the block was significantly longer in group LPB than group SA. The onset of sensory and motor block was significantly increased in group LPB than group SA. The intraoperative HR was significantly increased, and intraoperative MAP was significantly decreased in group SA compared to group LPB at 5, 10, 15, 20, 25 and 30 minutes. Postoperative HR and MAP was significantly increased in group SA compared to group LPB at 1 and 6 h. Postoperative VAS was significantly increased in group SA than group LPB at 1 and 6 h. The duration of sensory and motor block was significantly increased in group LPB than group SA. The time of postoperative first analgesic requirement was significantly longer and the total pethidine consumption in the 1st 24 h was significantly lower in group LPB than group SA. SA was associated with significant increase in hypotension, nausea, vomiting and headache. Conclusion: LPB is an effective alternative to SA as an anesthetic technique for femur fracture surgeries. LBP offers a more stable intraoperative hemodynamics and provides longer duration of analgesia postoperatively with less side effects. However, SA has shorter time for performing the block with earlier onset of sensory and motor block.

scholarly journals Spinal Anesthesia for Hip Fracture Surgery in an Elderly Patient with Acute Hypertensive Lung Edema

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Blood Pressure ◽  
Hip Fracture ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Lumbar Plexus ◽  
Lung Edema ◽  
The Third ◽  
Lumbar Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

Background: Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. We report a patient case of hip fracture with acute pulmonary edema treated with inguinal lumbar plexus block for analgesia and spinal anesthesia with low dose of isobaric bupivacaine for surgery. Case Report: A 85-year-old female was admitted with fracture of the hip. Echocardiography was performed, which found respiratory auscultation with crepitates rules in both lungs, associated with blood pressure of 205x 108 mmHg. Chest radiographs showed a bilateral alveolar infiltrate. After discussion with the surgical team and family members, previous analgesia was proposed for lumbar plexus block via inguinal and spinal anesthesia with low dose of isobaric bupivacaine. The surgery lasted 110 min. In the PACU, the vital signs were blood pressure 140x73 mmHg, heart rate 80 bpm and with 98% oxygen saturation in the nasal catheter, and diuresis of 2,400 mL, as well as cardiac enzymes are normal. Received 200 mL of a drink with high energy and transferred to infirmary. The patient was discharged to her home on the third postoperative day asymptomatic. Conclusions: The most important fact of this case is that the 85-years old patient with acute lung edema improved considerably after lumbar plexus block and spinal anesthesia with low doses and returned to her home on the third postoperative day.

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