In-plane three-step needle insertion technique for ultrasound-guided continuous femoral nerve block after total knee arthroplasty : a retrospective review of 488 cases
- Authors
- Shin, Hyeon Ju; Soh, Jung Sub; Lim, Hyong Hwan; Joo, Bumjoon; Lee, Hye Won; Lim, Hae Ja
- Issue Date
- 12월-2016
- Publisher
- KOREAN SOC ANESTHESIOLOGISTS
- Keywords
- Arthroplasty; Catheters; Femoral nerve; Knee; Ultrasonography
- Citation
- KOREAN JOURNAL OF ANESTHESIOLOGY, v.69, no.6, pp.587 - 591
- Indexed
- SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF ANESTHESIOLOGY
- Volume
- 69
- Number
- 6
- Start Page
- 587
- End Page
- 591
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/86708
- DOI
- 10.4097/kjae.2016.69.6.587
- ISSN
- 2005-6419
- 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.
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