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 language | English |
|---|---|
| Pages (from-to) | 587-591 |
| Number of pages | 5 |
| Journal | Korean Journal of Anesthesiology |
| Volume | 69 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2016 Dec 1 |
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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 journal › Article
}
TY - JOUR
T1 - In-plane three-step needle insertion technique for ultrasound-guided continuous femoral nerve block after total knee arthroplasty
T2 - A retrospective review of 488 cases
AU - Shin, Hyeon Ju
AU - Soh, Jung Sub
AU - Lim, Hyong Hwan
AU - Joo, Bumjoon
AU - Lee, Hye Won
AU - Lim, Hae Ja
PY - 2016/12/1
Y1 - 2016/12/1
N2 - 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.
AB - 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.
KW - Arthroplasty
KW - Catheters
KW - Femoral nerve
KW - Knee
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=85002939553&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85002939553&partnerID=8YFLogxK
U2 - 10.4097/kjae.2016.69.6.587
DO - 10.4097/kjae.2016.69.6.587
M3 - Article
AN - SCOPUS:85002939553
VL - 69
SP - 587
EP - 591
JO - Korean Journal of Anesthesiology
JF - Korean Journal of Anesthesiology
SN - 2005-6419
IS - 6
ER -