INTRODUCTION
Hip and knee arthroplasty are well known causes of severe postoperative pain. Although the place of peripheral nerve blockade in knee arthroplasty is well recognised (1, 2) its place in total hip arthroplasty is still not defined. In the case of major knee surgery, recent evidence suggests that early rehabilitation may be improved by use of regional anesthetic technique (3, 4). Regional blocks have thus gained acceptance for perioperative management of procedures on the knee and below, both as a complement to general anesthesia and as an alternative to centroneuraxial analgesia. For surgery of the hip, however, the role of peripheral nerve blockade needs to be defined (5, 6).
Total hip arthroplasty, one of the most frequently performed surgical procedures, generates significant postoperative pain that may be treated using regional anesthesia. Covert et al in his study concluded that when compared with other regimens, regional anesthesia provides superior pain relief and may favorably influence outcomes such as blood loss and thromboembolic events (7). Sensory innervation of the hip involves branches of the lumbar plexus and the sacral plexus. Local anesthetic may be directed to the lumbar plexus by an anterior approach …show more content…
They found that the maximum pain relief was superior in the Fascia iliaca block group both at rest (P < 0.01) and on movement (P = 0.02). The median total morphine consumption was 0 mg (interquartile range, 0-0 mg) in the Fascia iliaca block group and 6 mg (interquartile range, 5-7 mg) in the morphine group (P < 0.01). Pain relief was superior at all times and at all measurements in the Fascia iliaca block group. The study supports the use of Fascia iliaca block in acute management of hip fracture pain because it is an effective, easily learned procedure that also may reduce opioid side effects in this fragile, elderly group of patients
Hip and knee arthroplasty are well known causes of severe postoperative pain. Although the place of peripheral nerve blockade in knee arthroplasty is well recognised (1, 2) its place in total hip arthroplasty is still not defined. In the case of major knee surgery, recent evidence suggests that early rehabilitation may be improved by use of regional anesthetic technique (3, 4). Regional blocks have thus gained acceptance for perioperative management of procedures on the knee and below, both as a complement to general anesthesia and as an alternative to centroneuraxial analgesia. For surgery of the hip, however, the role of peripheral nerve blockade needs to be defined (5, 6).
Total hip arthroplasty, one of the most frequently performed surgical procedures, generates significant postoperative pain that may be treated using regional anesthesia. Covert et al in his study concluded that when compared with other regimens, regional anesthesia provides superior pain relief and may favorably influence outcomes such as blood loss and thromboembolic events (7). Sensory innervation of the hip involves branches of the lumbar plexus and the sacral plexus. Local anesthetic may be directed to the lumbar plexus by an anterior approach …show more content…
They found that the maximum pain relief was superior in the Fascia iliaca block group both at rest (P < 0.01) and on movement (P = 0.02). The median total morphine consumption was 0 mg (interquartile range, 0-0 mg) in the Fascia iliaca block group and 6 mg (interquartile range, 5-7 mg) in the morphine group (P < 0.01). Pain relief was superior at all times and at all measurements in the Fascia iliaca block group. The study supports the use of Fascia iliaca block in acute management of hip fracture pain because it is an effective, easily learned procedure that also may reduce opioid side effects in this fragile, elderly group of patients