In-plane three-step needle insertion technique for ultrasound-guided continuous femoral nerve block after total knee arthroplasty: A retrospective review of 488 cases

Hyeon Ju Shin, Jung Sub Soh, Hyong Hwan Lim, Bumjoon Joo, Hye Won Lee, Hae Ja Lim

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)

    Abstract

    Background: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. Methods: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique. The success rate and difficulties of catheter placement, clinical efficacy of analgesia, and complications were recorded. Results: Femoral catheters were placed with a 100% success rate. In 488 patients, real-time US imaging revealed easy separation of the fascia iliaca and the femoral nerve following injection of local anesthetic through a Tuohy needle. Verbal numerical rating scale pain scores (0–10) were 2.0 ± 1.2, 3.5 ± 1.9, 3.2 ± 1.7, 2.9 ± 1.3, and 2.5 ± 1.1 at 1, 6, 12, 24 and 48 h postoperatively. No femoral hematoma, femoral abscess, or neurologic complications, including paresthesia or neurologic deficits, were observed during the 8-week follow-up period. Conclusions: This retrospective study suggests that an in-plane three-step needle insertion technique for CFNB may reduce the risk of femoral nerve injury in anesthetized patients.

    Original languageEnglish
    Pages (from-to)587-591
    Number of pages5
    JournalKorean journal of anesthesiology
    Volume69
    Issue number6
    DOIs
    Publication statusPublished - 2016 Dec

    Keywords

    • Arthroplasty
    • Catheters
    • Femoral nerve
    • Knee
    • Ultrasonography

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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