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 journalArticle

4 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 1

Fingerprint

Femoral Nerve
Knee Replacement Arthroplasties
Nerve Block
Needles
Thigh
Analgesia
Catheters
Retrospective Studies
Paresthesia
Spinal Anesthesia
Fascia
Wounds and Injuries
Neurologic Manifestations
Local Anesthetics
Hematoma
Abscess
General Anesthesia
Nervous System
Ultrasonography
Pain

Keywords

  • Arthroplasty
  • Catheters
  • Femoral nerve
  • Knee
  • Ultrasonography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

In-plane three-step needle insertion technique for ultrasound-guided continuous femoral nerve block after total knee arthroplasty : A retrospective review of 488 cases. / Shin, Hyeon Ju; Soh, Jung Sub; Lim, Hyong Hwan; Joo, Bumjoon; Lee, Hye Won; Lim, Hae Ja.

In: Korean Journal of Anesthesiology, Vol. 69, No. 6, 01.12.2016, p. 587-591.

Research output: Contribution to journalArticle

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