Efficacy of continuous femoral three-in-one nerve block using stimulating nerve catheter and non stimulating nerve catheter for postoperative analgesia in surgeries over thigh: a comparative study
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 4
Abstract
Introduction Continuous femoral analgesia provides extended pain relief for surgeries over thigh Successful continuous peripheral nerve analgesia depends on catheter proximity to the target nerve and stimulating catheters may allow more accurate placement of catheters Hence we conducted a study to compare the efficacy of stimulating nerve catheter and non stimulating nerve catheter in femoral 3in1 nerve block for postoperative analgesiaMaterials and Methods 60 ASA grade I II patients of either sex between 18 to 65 years of age posted for total knee replacement surgery were randomly allocated into two groups Group SC stimulating catheter and Group NSCnon stimulating catheter All patients received subarachnoid block and after completion of surgery femoral catheter stimulatingnon stimulating depending on the group was placed using peripheral nerve stimulator for postoperative analgesia When spinal level regressed to T12 dermatomal level InjBupivacaine 025 20ml with InjLignocaine 1 10ml was given The patients were followed for next 24 hours from the time of first bolus After the 1st bolus when the VRS score was 3 intermittent boluses of InjBupivacaine 025 15 ml with InjFentanyl 05gkg were given All patients received Inj Paracetamol 20 mgkg IV 6 hourly In case patient still had VRS score 3 then rescue analgesia in the form of InjDiclofenac sodium 1 mgkg IV was given Two groups were observed for total duration of sensory block time from 1st bolus dose till the time VAS score was 3 requirement of analgesic solution requirement of rescue analgesia and any complication or side effectsResults Total duration of sensory block in group SC was 940021 hours compared to 710023 hours in group NSC p00001 Total requirement of analgesic solution was less in SC group in comparison to NSC group No significant complication observed in either groupConclusion Stimulating nerve catheter provides longer duration of sensory blockade with decreased requirement of local anaesthetic solution and opioid when compared to non stimulating nerve catheterKeywords Continuous femoral threeinone nerve block Stimulating catheter Non stimulating catheter Postoperative analgesia
Authors and Affiliations
Nitin Choudhary, Alpa Patel, Utpala Kharod, Vikash Dr
Keywords
Related Articles
- EP ID EP476512
- DOI 10.18231/2394-4994.2018.0105
- Views 54
- Downloads 0
Retrosternal goitre: Anaesthetic implications and management
Large retrosternal goitre is a challenge to the anaesthesiologist and the surgeon We describe the successful anaesthetic management of a 44 year old male patient with extensive retrosternal goitre with severe tracheal co...
Comparison of oxygenation and ventilation parameters between proseal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries: a prospective observational study
Introduction Use of endotracheal tube ETT has many limitations There is a need for an airway device with similar safety and good side effect profile In this prospective observational study the oxygenation and ventilation...
Comparison of two supraglottic airways - I-gel and Proseal laryngeal mask airway for ease of insertion and hemodynamic stability
Introduction and Aims: Supraglottic airway devices are safe and efficient in airway management. I-gelTM and ProsealTM laryngeal mask airway are supraglottic airway devices which are used to secure and maintain airway dur...
Comparative assessment of intubating conditions in adult patients using C-MAC® Video laryngoscope and Macintosh direct laryngoscope in routine intubations
Background and Aims: Securing the airway with an endotracheal tube is considered the standard of care for surgeries requiring general anaesthesia. The Macintosh laryngoscope is the most commonly used device for directly...
Infantile hypertrophic pyloric stenosis - does optimal pre-operative stabilisation enhance recovery: a retrospective study
Introduction: Infantile hypertrophic pyloric stenosis is a pathological condition of early infancy which poses many challenges to both treating surgeons and anaesthesiologists. Correction of acid base imbalance and dysel...