The analgesic efficiency of continuous femoral nerve blockade after total hip arthroplasty (THA) is not improved by the use of a stimulating catheter

2005 ◽  
Vol 30 (5) ◽  
pp. 4-4 ◽  
Author(s):  
M MALISSE ◽  
P BASSET ◽  
T FERRANT ◽  
R FUZIER ◽  
F SINGELYN
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Nerve ◽  
Nerve Blockade ◽  
Total Hip ◽  
Stimulating Catheter

Femoral Nerve Palsy Following Total Hip Arthroplasty: Incidence and Course of Recovery

2018 ◽  
Vol 33 (4) ◽  
pp. 1194-1199 ◽  
Author(s):  
Andrew N. Fleischman ◽  
Richard H. Rothman ◽  
Javad Parvizi
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Nerve Palsy ◽  
Femoral Nerve ◽  
Total Hip ◽  
Femoral Nerve Palsy

scholarly journals Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Shoji Nishio ◽  
Shigeo Fukunishi ◽  
Tomokazu Fukui ◽  
Yuki Fujihara ◽  
Shohei Okahisa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Total Hip Arthroplasty ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Sciatic Nerve Block ◽  
Nerve Blockade ◽  
Continuous Femoral Nerve Block

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

scholarly journals Perioperative Nerve Injury after Total Hip Arthroplasty

2011 ◽  
Vol 115 (6) ◽  
pp. 1172-1178 ◽  
Author(s):  
Adam K. Jacob ◽  
Carlos B. Mantilla ◽  
Hans P. Sviggum ◽  
Darrell R. Schroeder ◽  
Mark W. Pagnano ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Hip Arthroplasty ◽  
Female Gender ◽  
Nerve Blockade ◽  
Neurologic Recovery ◽  
Total Hip ◽  
Peripheral Nerve Blockade ◽  
Clinical Benefits

Background Perioperative nerve injury (PNI) is a recognized complication of total hip arthroplasty (THA). Regional anesthesia (RA) techniques may increase the risk of neurologic injury. Using a retrospective cohort study, the authors tested the hypothesis that use of RA increases the risk for PNI after elective THA. Methods All adult patients who underwent elective THA at Mayo Clinic during a 20-yr period were included. The primary outcome was the presence of a new PNI within 3 months of surgery. Multivariable logistic regression was used to evaluate patient, surgical, and anesthetic risk factors for PNI. Results Of 12,998 patients undergoing THA, 93 experienced PNI (incidence = 0.72%; 95% CI 0.58-0.88%). PNI was not associated with type of anesthesia (OR = 0.72 for neuraxial-combined vs. general; 95% CI 0.46-1.14) or peripheral nerve blockade (OR = 0.65; 95% CI 0.34-1.21). The risk for PNI was associated with younger age (OR = 0.79 per 10-yr increase; 95% CI 0.69-0.90), female gender (OR = 1.72; 95% CI 1.12-2.64), longer operations (OR = 1.10 per 30-min increase; 95% CI 1.03-1.18) or posterior surgical approach (OR = 1.91 vs. anterior approach; 95% CI 1.22-2.99). Neurologic recovery was not influenced by the use of RA techniques in patients with PNI. Conclusions The risk for PNI after THA was not increased with the use of neuraxial anesthesia or peripheral nerve blockade. Neurologic recovery in patients who experienced PNI was not affected by the use of RA. These results support the use of RA techniques in patients undergoing elective THA given their known functional and clinical benefits.

A new anterior total hip arthroplasty reduction technique for patients who require leg lengthening

2020 ◽  
Vol 30 (5) ◽  
pp. 587-591
Author(s):  
Kazuhiro Oinuma ◽  
Hideaki Shiratsuchi ◽  
Yoshiatsu Nakakita ◽  
Yoko Miura ◽  
Taishi Ninomiya
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Nerve ◽  
Direct Anterior Approach ◽  
Reduction Technique ◽  
Leg Lengthening ◽  
Total Hip ◽  
Traditional Technique ◽  
Shortening Osteotomy ◽  
Grade Ii

Background: When performing anterior total hip arthroplasty (THA) for patients who require leg lengthening, surgeons often encounter difficulties during reduction due to soft tissue tightness. The purpose of this study was to introduce a new THA reduction technique for these patients. Methods: Between October 2018 and September 2019, 545 THAs were performed. In 15 hips (2.8%), reduction was not achieved with a traditional technique. The preoperative diagnosis was Crowe grade II in 4 hips, Crowe grade III in 4 hips, Crowe grade IV in 1 hip, and sequelae of Legg-Calvé-Perthes disease in 6 hips. All procedures were performed using a direct anterior approach. The new reduction technique was to use a lever hooked on the acetabular teardrop as a counter force against the preserved muscles. The lever was connected to the impactor with a wire and the counterforce was transmitted to the impactor. Results: Reduction was achieved in all cases without shortening osteotomy or muscle release. The mean lengthening of the operated limb was 30 mm (range 13–59 mm). Neither sciatic nor femoral nerve palsy were observed. Conclusion: We developed a new anterior THA reduction technique for patients who require leg lengthening. When the centre of the femoral head was reduced to the superior edge of the cup with the traditional technique, reduction was safely achieved with this technique.

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