USG GUIDED FEMORAL & LATERAL CUTANEOUS NERVE BLOCK AS SAVIOUR- ANAESTHETIC MANAGEMENT OF PATIENT OF CKD-ESRD WITH DIFFICULT AIRWAY & COAGULOPATHY POSTED FOR NOVEL PROSTHETIC FEMORO-FEMORAL AV FISTULA.

2021 ◽  
pp. 122-123
Author(s):  
Vipan Kumar ◽  
Vishal Vashist ◽  
Bhanu Gupta
Keyword(s):  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Prosthetic Graft ◽  
Anaesthetic Management ◽  
Cutaneous Nerve ◽  
Av Fistula ◽  
Early Maturation ◽  
Ckd Stage ◽  
Lateral Cutaneous Nerve

Anaesthetic management for creation of a novel prosthetic femoro-femoral arteriovenous stula (AV) in 65 years old male patient k/c/o hypertension with CKD (Stage V, [ESRD] haemodialysis dependent for last 1.5 years with difcult airway and deranged coagulation prole. AV stula was initially created in upper limb which blocked 6 weeks back. Subsequently dialysis was done by dialysis catheter as temporary method and femoro-femoral AV stula creation using prosthetic graft was planned due to its early maturation time (7 days). Central neuraxial blocks were contraindicated because of deranged coagulation prole. Patient is also high risk for GA i/v/o ESRD and difcult airway. Therefore we planned for RA in the form of USG guided Femoral Nerve Block and Lateral Cutaneous Nerve (LCN) of thigh block. Femoral Nerve Block (FNB) and Lateral Cutaneous Nerve block (LCN) was performed under ultrasound guidance in real time using 20 and 10ml of 0.25% Bupivacaine respectively. After establishing block effect, surgery was performed solely under block with stable perioperative course.

scholarly journals The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932199663
Author(s):  
Mustafa Kaçmaz ◽  
Zeynep Yüksel Turhan
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Significant Difference ◽  
Total Knee

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

scholarly journals Intra-articular Morphine and Ropivacaine Injection Provides Efficacious Analgesia As Compared With Femoral Nerve Block in the First 24 Hours After ACL Reconstruction: Results From a Bone–Patellar Tendon–Bone Graft in an Adolescent Population

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098590
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds ◽  
Tracey P. Bastrom ◽  
...  
Keyword(s):  
Pain Management ◽  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Single Shot ◽  
Pain Scores ◽  
Peripheral Block ◽  
Bone Patellar Tendon

Background: Opioid consumption and patient satisfaction are influenced by a surgeon’s pain-management protocol as well as the use of adjunctive pain mediators. Two commonly utilized adjunctive pain modifiers for anterior cruciate ligament (ACL) reconstruction are femoral nerve blockade and intra-articular injection; however, debate remains regarding the more efficacious methodology. Hypothesis: We hypothesized that intra-articular injection with ropivacaine and morphine would be found to be as efficacious as a femoral nerve block for postoperative pain management in the first 24 hours after bone–patellar tendon–bone (BTB) ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Charts were retrospectively reviewed for BTB ACL reconstructions performed by a single pediatric orthopaedic surgeon from 2013 to 2019. Overall, 116 patients were identified: 58 received intra-articular injection, and 58 received single-shot femoral nerve block. All patients were admitted for 24 hours. Pain scores were assessed every 4 hours. Morphine milligram equivalents (MMEs) consumed were tabulated for each patient. Results: Opioid use was 24.3 MMEs in patients treated with intra-articular injection versus 28.5 MMEs in those with peripheral block ( P = .108). Consumption of MMEs was greater in the intra-articular group in the 0- to 4-hour period (7.1 vs 4.6 MMEs; P = .008). There was significantly less MME consumption in patients receiving intra-articular injection versus peripheral block at 16 to 20 hours (3.2 vs 5.6 MMEs; P = .01) and 20 to 24 hours (3.8 vs 6.5 MMEs; P < .001). Mean pain scores were not significantly different over the 24-hour period (peripheral block, 2.7; intra-articular injection, 3.0; P = .19). Conclusion: Within the limitations of this study, we could identify no significant difference in MME consumption between the single-shot femoral nerve block group and intra-articular injection group in the first 24 hours postoperatively. While peripheral block is associated with lower opioid consumption in the first 4 hours after surgery, patients receiving intra-articular block require fewer opioids 16 to 24 hours postoperatively. Given these findings, we propose that intra-articular injection is a viable alternative for analgesia in adolescent patients undergoing BTB ACL reconstruction.

scholarly journals Continuous Tunnelled Femoral Nerve Block for Palliative Care of a Patient with Metastatic Osteosarcoma

2010 ◽  
Vol 38 (3) ◽  
pp. 563-565 ◽  
Author(s):  
H. L. Pacenta ◽  
R. N. Kaddoum ◽  
L. A. Pereiras ◽  
E. J. Chidiac ◽  
L. L. Burgoyne
Keyword(s):  
Palliative Care ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Metastatic Osteosarcoma
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