2013, Number 1
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Revista Cubana de Anestesiología y Reanimación 2013; 12 (1)
Peripheral nerve block for the postoperative pain relief after arthroscopy of the hip
Márquez AJJ, Restrepo GCE, Márquez AWH
Language: Spanish
References: 20
Page: 20-29
PDF size: 57.61 Kb.
ABSTRACT
Background: The treatment of postoperative pain after arthroscopy of the hip is a
challenge and there are no known studies related to its treatment which have been
based on regional block.
Objectives: To determine the behaviour of postoperative pain and the satisfaction of
the patients who have been treated with arthroscopy of the hip with femoral block,
lumbar plexus block or intra-articular infiltration.
Methods: All the anaesthetic records of 61 patients that required arthroscopy of the
hip under general anaesthesia using femoral block with 0,3 mL/kg of Levobupivacaine
0,375 %, lumbar plexus block with 0,4 mL/kg of Levobupivacaine 0,375 % or intraarticular
infiltration with 20 mL of Bupivacaine 0,5 % were checked. The data about
postoperative pain which had been assessed with visual analogous scale at the 15,
30, 60 and 120 minutes and at the 24 hours, the satisfaction of the patients at the
moment of the discharge from hospital at the 24 hours, the sensitive and motor block
and the need to use Morphine in the postoperative phase were also checked.
Results: The group of patients that were treated with intra-articular infiltration
presented the highest levels of pain in almost all evaluated moments. As compared
with the lumbar plexus block, more patients that underwent femoral block presented
higher levels of pain in almost all moments. Out of the patients in the group that was
treated with intra-articular infiltration, the 55 % received Morphine at any
postoperative moment as well as the 28,5 % treated with femoral block and the 15 %
who underwent lumbar plexus block. The level of patients´ satisfaction was high and
similar in the three groups.
Conclusions: Postoperative analgesia for arthroscopy of the hip was better with
lumbar plexus block as compared with femoral block or intra-articular infiltration.
REFERENCES
Stevens MS, Legay DA, Glazebrook MA, Amirault D. The evidence for hip arthroscopy: grading the current indications. Arthroscopy. United States: 2010 Arthroscopy Association of North America. Published by Elsevier Inc; 2010. p. 1370- 83.
Botser IB, Smith TW Jr., Nasser R, Domb BG. Open surgical dislocation versus arthroscopy for femoroacetabular impingement: a comparison of clinical outcomes. Arthroscopy. United States: A 2011 Arthroscopy Association of North America. Published by Elsevier Inc; 2011. p. 270-8.
Lee EM, Murphy KP, Ben-David B. Postoperative analgesia for hip arthroscopy: combined L1 and L2 paravertebral blocks. J Clin Anesth. United States 2008;20(6):462-5.
Hebl JR, Dilger JA, Byer DE, Kopp SL, Stevens SR, Pagnano MW, et al. A preemptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery. Anesth Pain Med. United States 2008;33(6):510-7.
Touray ST, de Leeuw MA, Zuurmond WW, Perez RS. Psoas compartment block for lower extremity surgery: a meta-analysis. Br J Anaesth Engl. 2008;101(6):750-60.
Bunn J, Villar R, ed. The efficacy of post-operative analgesic regimes following hip arthroscopy. JBJS (Br). 2010;92(Supl IV):611.
Baker JFMC, Byrne DP, Hunter K, Eustace N, Mulhall KJ. Analgesic control after hip arthroscopy: a randomised, double-blinded trial comparing portal with intra-articular infiltration of bupivacaine. Hip Int. 2011;21(3):373-7.
NYSORA. Lumbar Plexus Block. 2009. En línea. [Consultado 20/05/2012] Disponible en: http://www.nysora.com/peripheral_nerve_blocks/nerve_stimulator_techniques/3059 -lumbar_plexus_block.html
Ultrasound for Regional Anesthesia. Canada; 2008 [Consultado: 21/05/2012]. Femoral Nerve Block. Disponible en: http://www.usra.ca/sb_femoral
Marino J, Russo J, Kenny M, Herenstein R, Livote E, Chelly JE. Continuous lumbar plexus block for postoperative pain control after total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. United States 2009;91(1):29-37.
Capdevila X, Biboulet P, Morau D, Bernard N, Deschodt J, Lopez S, et al. Continuous three-in-one block for postoperative pain after lower limb orthopedic surgery: where do the catheters go? Anesth Analg. 2002;94(4):1001-6.
Marhofer P, Nasel C, Sitzwohl C, Kapral S. Magnetic resonance imaging of the distribution of local anesthetic during the three-in-one block. Anesth Analg. 2000;90(1):119-24.
Morgenthaler K, Bauer C, Ziegeler S, Mencke T, Werth M, Seil R, et al. Intraarticular bupivacaine following hip joint arthroscopy. Effect on postoperative pain. Anaesthesist. 2007;56(11):1128-32.
Baker JF, Byrne DP, Hunter K, Mulhall KJ. Post-operative opiate requirements after hip arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2011;19(8):1399-402.
Vadivelu N, Mitra S, Hines RL. Peripheral opioid receptor agonists for analgesia: a comprehensive review. J Opioid Manag. 2011;7(1):55-68.
Wu CL, Naqibuddin M, Fleisher LA. Measurement of patient satisfaction as an outcome of regional anesthesia and analgesia: a systematic review. Reg Anesth Pain Med. 2001;26(3):196-208.
Konan S, Rhee SJ, Haddad FS. Hip arthroscopy: analysis of a single surgeon's learning experience. J Bone Joint Surg Am. 2011;93(Suppl 2):52-6.
Chanthong P, Abrishami A, Wong J, Herrera F, Chung F. Systematic review of questionnaires measuring patient satisfaction in ambulatory anesthesia. . 2009;110(5):1061-7.
Wahoff M, Ryan M. Rehabilitation after hip femoroacetabular impingement arthroscopy. Clin Sports Med. 2011;30(2):463-82.
Liu SS, Ngeow J, John RS. Evidence basis for ultrasound-guided block characteristics: onset, quality, and duration. Reg Anesth Pain Med. United States 2010;35(2 Suppl):S26-35.