Spinal Anesthesia with Peripheral Nerve Block versus General Anesthesia with Peripheral Nerve Block for Elective Foot and Ankle Surgeries: A Retrospective Single-center Study

2021 ◽  
Author(s):  
Tianxiang Zhang ◽  
Yunfei Cao ◽  
Rong Xu ◽  
Lianfei Xia ◽  
Youhua Wu
Keyword(s):  
Peripheral Nerve ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Peripheral Nerve Block ◽  
Foot And Ankle ◽  
Single Center ◽  
Single Center Study ◽  
Center Study

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

scholarly journals Functional recovery with peripheral nerve block versus general anesthesia for upper limb surgery: a systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Jennifer Héroux ◽  
Emilie Belley-Côté ◽  
Pablo Echavé ◽  
Marie-Josée Loignon ◽  
Pierre-Olivier Bessette ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Nerve ◽  
General Anesthesia ◽  
Nerve Block ◽  
Upper Limb ◽  
Functional Recovery ◽  
Peripheral Nerve Block ◽  
Upper Limb Surgery ◽  
Grade Methodology ◽  
The Impact

Abstract Background Peripheral nerve block is a single injection that inhibits the transmission of peripheral nerve impulses to the central nervous system. The inhibition of the nociceptive impulse may decrease the occurrence of muscle spasm following mobilization postoperatively. This mechanism may contribute to a better functional recovery following upper limb surgery. This systematic review will investigate the impact of peripheral nerve block on functional recovery after an upper limb surgery. Methods We will search studies comparing peripheral nerve block to general anesthesia for upper limb surgery in the following databases: CENTRAL, MEDLINE (Ovid), CINAHL, EMBASE, and Scopus. In duplicate, independent reviewers will assess eligibility, evaluate risk of bias, and abstract data on type of peripheral nerve block and functional outcome. Where possible, we will pool results using a random effects model. For each outcome, we will assess the quality of evidence using GRADE methodology. Discussion We aim to summarize the available evidence comparing functional recovery with peripheral nerve block versus general anesthesia for upper limb surgery. These data will inform the design of a trial on the topic. Systematic review registration PROSPERO CRD42018116298

scholarly journals Comparison of the Combined Femoral and Lateral Femoral Cutaneous Nerve Block Plus Popliteal Block with Spinal Anesthesia for Thigh Tourniquet Pain During Foot or Ankle Surgery: A Randomized Clinical Trial

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Shideh Dabir ◽  
Faramarz Mosaffa ◽  
Behnam Hosseini ◽  
Vahideh Alimoradi
Keyword(s):  
Peripheral Nerve ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Peripheral Nerve Block ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Tourniquet Pain ◽  
Pain Scores ◽  
Femoral Cutaneous Nerve ◽  
Popliteal Block

Background: A pneumatic thigh tourniquet is routinely used during lower-extremity orthopedic surgeries to provide a bloodless field. When using peripheral nerve blocks, tourniquet-related thigh pain and discomfort limit their routine use as an anesthetic method. Objectives: The aim of the present prospective, randomized study was to compare the efficacy of combined femoral nerve/lateral femoral cutaneous nerve block technique and spinal anesthesia on intraoperative thigh tourniquet pain. Methods: We studied 60 American Society of Anesthesiologists physical status I-II patients scheduled for orthopedic surgery on the foot or ankle using a pneumatic thigh tourniquet. They were randomly divided into two equal groups. The peripheral nerve block group received a combined popliteal, femoral, and lateral femoral cutaneous nerve block under ultrasound-guidance. In both groups, the level of sensory blockade was determined by the pinprick test. The block performance time, anesthetic effect time, intraoperative tourniquet pain scores, the amount of fentanyl and ketamine, surgery duration, and patient’s satisfaction were recorded. Results: The patients’ characteristics were comparable in the two groups. The mean duration of block performance and anesthetic effect, intraoperative tourniquet pain scores, and the amount of intravenous analgesics in the peripheral nerve block group were significantly greater than those in the spinal anesthesia group. Patient satisfaction was similar in both groups. Conclusions: Spinal anesthesia is significantly more effective than the peripheral nerve block method in reducing thigh tourniquet pain. A combined femoral and lateral femoral cutaneous nerve block with popliteal block can improve thigh tourniquet tolerance if supplemented with intravenous analgesics.

Comparing outcomes after peripheral nerve block versus general anesthesia for lower extremity amputation: a nationwide exploratory retrospective cohort study in Japan

2020 ◽  
Vol 45 (6) ◽  
pp. 399-404 ◽  
Author(s):  
Hiroaki Abe ◽  
Masahiko Sumitani ◽  
Hiroki Matsui ◽  
Shotaro Aso ◽  
Reo Inoue ◽  
...  
Keyword(s):  
Propensity Score ◽  
Lower Extremity ◽  
Peripheral Nerve ◽  
General Anesthesia ◽  
Nerve Block ◽  
Postoperative Delirium ◽  
Peripheral Nerve Block ◽  
Lower Extremity Amputation ◽  
Significant Difference ◽  
Extremity Amputation

Background and objectivesThe health benefits of peripheral nerve block (PNB) on postoperative complications after lower extremity amputation (LEA) compared with general anesthesia (GA) remains controversial. We performed a retrospective propensity score-matched cohort analysis to compare major outcomes after LEA with PNB versus GA.Materials and methodsWe used a nationwide inpatient database in Japan to compare patient outcomes after LEA with PNB versus GA from 2010 to 2016. Our primary outcome was 30-day mortality after LEA. The incidence of composite morbidity from life-threatening complications and of delirium within 30 days after LEA were secondary outcomes. We conducted propensity score-matched analyses of patients who underwent below knee or foot amputation using 36 covariates. Logistic regression analyses fitted with generalized estimating equations were performed to calculate ORs and their 95% CIs.ResultsOf 11 796 patients, 747 received PNB and 11 049 received GA. After one-to-four propensity score matching, 747 patients were included in the PNB group and 2988 in the GA group. The adjusted ORs for postoperative mortality, composite morbidity and delirium within 30 days after LEA were 1.11 (95% CI 0.75 to 1.64), 1.15 (95% CI 0.85 t o1.56) and 0.75 (95% CI 0.57 to 0.98), respectively, for the PNB group with reference to the GA group.ConclusionsThere was no significant difference between groups in 30-day mortality or composite morbidity. The PNB group showed a significantly lower risk of postoperative delirium than the GA group. Our findings suggest that PNB may have advantages over GA in preventing postoperative delirium among patients undergoing LEA.

scholarly journals Combination of general anesthesia and peripheral nerve block with low-dose ropivacaine reduces postoperative pain for several days after outpatient arthroscopy

Medicine ◽  
2017 ◽  
Vol 96 (6) ◽  
pp. e6046 ◽  
Author(s):  
Benedikt Büttner ◽  
Ashham Mansur ◽  
José Hinz ◽  
Joachim Erlenwein ◽  
Martin Bauer ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Peripheral Nerve ◽  
General Anesthesia ◽  
Nerve Block ◽  
Low Dose ◽  
Peripheral Nerve Block
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