In-plane three-step needle insertion technique for ultrasound-guided continuous femoral nerve block after total knee arthroplasty: a retrospective review of 488 cases.
10.4097/kjae.2016.69.6.587
- Author:
Hyeon Ju SHIN
1
;
Jung Sub SOH
;
Hyong Hwan LIM
;
Bumjoon JOO
;
Hye Won LEE
;
Hae Ja LIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea. may335@naver.com
- Publication Type:Original Article
- Keywords:
Arthroplasty;
Catheters;
Femoral nerve;
Knee;
Ultrasonography
- MeSH:
Abscess;
Analgesia;
Anesthesia, Spinal;
Arthroplasty;
Arthroplasty, Replacement, Knee*;
Catheters;
Fascia;
Femoral Nerve*;
Follow-Up Studies;
Hematoma;
Humans;
Knee;
Needles*;
Neurologic Manifestations;
Paresthesia;
Retrospective Studies*;
Treatment Outcome;
Ultrasonography
- From:Korean Journal of Anesthesiology
2016;69(6):587-591
- CountryRepublic of Korea
- Language:English
-
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.
