Key result
Combined femoral, sciatic, obturator, and LFC blocks yield 100% opioid-free anesthesia in hip hemiarthroplasty.
Why the study?
The efficacy of combined femoral, sciatic, obturator, and lateral femoral cutaneous nerve blocks for anesthesia in hip hemiarthroplasty was unknown.
Does combined major lower limb nerve block provide adequate anesthesia in patients undergoing hip hemiarthroplasty?
Observational (n=20)
Does combined major lower limb nerve block provide adequate anesthesia in patients undergoing hip hemiarthroplasty?
Combined major lower limb nerve blocks can provide adequate anesthesia for hip hemiarthroplasty without the need for intraoperative opioids.
Answers are grounded in this paper and cite their sources.
May support opioid-free regional anesthesia for hip hemiarthroplasty in select cases; leaves open reliability in larger trials.
BACKGROUND: Major lower limb nerve blocks are relatively safe techniques. However, their efficacy for hip hemiarthroplasty is unknown. The objective of this study was to determine the effectiveness of combined femoral, sciatic, obturator and lateral femoral cutaneous (LFC) nerve blocks in providing adequate anesthesia for hip hemiarthroplasty. MATERIALS AND METHODS: A total of 20 patients with fracture neck femur; who underwent hip hemiarthroplasty, participated in this observational study. In the induction room, all patients received ultrasound-guided femoral, proximal obturator, LFC and parasacral sciatic nerve blocks in addition to local infiltration at the proximal site of the skin incision. Anesthesia was considered to be adequate only if the surgery was completed without any requirement for opioid administration. RESULTS: All patients (100% [95% confidence interval, 86-100%]) had adequate anesthesia. Seventeen patients (85% [95% confidence interval, 63-96%] had mild discomfort during the reduction of the prosthetic femur head back into the hip socket; however, no supplementary analgesics were required. CONCLUSION: The combined femoral, sciatic, obturator and LFC nerve blocks in addition to local infiltration at the proximal site of skin incision could provide adequate anesthesia for hip hemiarthroplasty. Light sedation before reduction of the prosthetic femur head back into the hip socket is advisable.
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Taha et al. (2014) conducted an observational in Fracture neck femur (n=20). Combined femoral, sciatic, obturator and lateral femoral cutaneous (LFC) nerve blocks with local infiltration was evaluated on Adequate anesthesia (surgery completed without any requirement for opioid administration) (95% CI 86-100%). Combined femoral, sciatic, obturator, and LFC nerve blocks provided adequate anesthesia without opioid administration in 100% (95% CI 86-100%) of patients undergoing hip hemiarthroplasty.
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