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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2024, Number 6

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Acta Ortop Mex 2024; 38 (6)

Effectiveness of peripheral nerve blockade in pain management for patients undergoing anterior cruciate ligament reconstruction: a retrospective observational study

Valderrama-Ronco J, Acevedo M, Hernández R, Gardella E, León A, Carredano X, León A, Redenz G

Language: Spanish
References: 30
Page: 377-382
PDF size: 290.20 Kb.


ABSTRACT

Introduction: therapeutic equivalence has been established in the effectiveness of peripheral nerve blocks in the management of pain in the postoperative period of anterior cruciate ligament reconstruction. However, it is unknown whether this effect is modulated by the anesthesiologist's experience. The objective was to describe the effectiveness of peripheral nerve blocks during the first 24 hours of the postoperative period, considering patient characteristics and the anesthesiologist's experience. Material and methods: a retrospective cohort study was conducted from 2015 to 2017. Patients who received a femoral canal block, femoral nerve block, or spinal anesthesia were included. All data were obtained from the patient's medical records, with pain assessed using a visual analog scale recorded in the medical records. A robust, non-parametric kernel regression model was generated to estimate the effect of the variables. Results: out of 480 clinical records, 168 were included in the analysis. The period of greatest pain was between eight and 12 hours, with a non-success rate of up to 22.9%. No differences were found between peripheral nerve blocks. The anesthesiologist's experience did not influence the analgesic effect, while the use of a bone-tendon-bone graft determined greater postoperative pain. Conclusion: in minimally invasive procedures, good pain management outcomes could be observed independently of the anesthesiologist's experience.


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EVIDENCE LEVEL

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