Usefulness of Ultrasound-Guided Lower Extremity Nerve Blockade in Surgery for Patellar Fracture
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the usefulness of ultrasound-guided nerve blockade in patellar fracture surgery.Materials and Methods: Twenty-three patients who underwent metal fixation under ultrasound-guided lower extremity blockade after diagnosis of patellar fracture from July 2011 to June 2012 were enrolled in this study. Under ultrasound guidance, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and sciatic nerve blockades were performed. For evaluation of anesthesia, interference with overall surgery, such as intraoperative knee pain and tourniquet pain, was checked. Individual anesthetic complications, satisfaction with nerve blocks, and choice of future anesthesia method were investigated.Results: Nineteen patients underwent surgery without any pain and 4 patients with mild pain. Satisfaction was excellent in 17 patients, good in 5, and unsatisfactory in 1. No complications such as infection or nerve injury occurred. In terms of selection of future anesthesia, 22 patients chose a nerve blockade of the lower extremity under ultrasound guidance, and one chose general anesthesia.Conclusions: Overall, ultrasound-guided nerve block of the lower extremity for patellar fracture surgery showed satisfactory results. Therefore, it could be a useful method to prevent complications associated with general or spinal anesthesia.
Abstract
Purpose: To evaluate the usefulness of ultrasound-guided nerve blockade in patellar fracture surgery.Materials and Methods: Twenty-three patients who underwent metal fixation under ultrasound-guided lower extremity blockade after diagnosis of patellar fracture from July 2011 to June 2012 were enrolled in this study. Under ultrasound guidance, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and sciatic nerve blockades were performed. For evaluation of anesthesia, interference with overall surgery, such as intraoperative knee pain and tourniquet pain, was checked. Individual anesthetic complications, satisfaction with nerve blocks, and choice of future anesthesia method were investigated.Results: Nineteen patients underwent surgery without any pain and 4 patients with mild pain. Satisfaction was excellent in 17 patients, good in 5, and unsatisfactory in 1. No complications such as infection or nerve injury occurred. In terms of selection of future anesthesia, 22 patients chose a nerve blockade of the lower extremity under ultrasound guidance, and one chose general anesthesia.Conclusions: Overall, ultrasound-guided nerve block of the lower extremity for patellar fracture surgery showed satisfactory results. Therefore, it could be a useful method to prevent complications associated with general or spinal anesthesia.
참고문헌 (27)
- Sarrafian SK, "Ankle-foot peripheral nerve block for mid and forefoot surgery", Foot Ankle, 4, pp.86~90 (1983)
- Hansen E, "Popliteal fossa neural blockade as the sole anesthetic technique for outpatient foot and ankle surgery", Foot Ankle Int, 21, pp.38~44 (2000)
- Varitimidis SE, "Triple nerve block at the knee for foot and ankle surgery performed by the surgeon : difficulties and efficiency", Foot Ankle Int, 30, pp.854~859 (2009)
- Flood BM, "Intravenous regional anaesthesia for lower limb orthopaedic surgery", Ann R Coll Surg Engl, 70, pp.257~ (1988)
- Domingo-Triado V, "Ultrasound guidance for lateral midfemoral sciatic nerve block : a prospective, comparative, randomized study", Anesth Analg, 104, pp.1270~1274 (2007)
- Triado VD, "A comparison of lateral popliteal versus lateral midfemoral sciatic nerve blockade using ropivacaine 0.5%", Reg Anesth Pain Med, 29, pp.23~27 (2004)
- Marhofer P, "Ultrasound guidance in regional anaesthesia", Br J Anaesth, 94, pp.7~17 (2005)
- Perlas A, "Ultrasound guidance improves the success of sciatic nerve block at the popliteal fossa", Reg Anesth Pain Med, 33, pp.259~265 (2008)
- Shaw AD, "Daystay hamstring ACL reconstruction performed under regional anaesthesia", Knee, 12, pp.271~273 (2005)
- Salinas FV, "The effect of single-injection femoral nerve block versus continuous femoral nerve block after total knee arthroplasty on hospital length of stay and long-term functional recovery within an established clinical pathway", Anesth Analg, 102, pp.1234~1239 (2006)
- Kosel J, "The use of regional anesthetic techniques in pain management in patients undergoing primary knee replacement", Ortop Traumatol Rehabil, 14, pp.315~328 (2012)
- Luhmann SJ, "Use of femoral nerve blocks in adolescents undergoing patellar realignment surgery", Am J Orthop(Belle Mead NJ), 37, pp.39~43 (2008)
- Auroy Y, "Major complications of regional anesthesia in France : the SOS Regional Anesthesia Hotline Service", Anesthesiology, 97, pp.1274~1280 (2002)
- Cabrera LS, "Paradoxical reaction to midazolam reversed with flumazenil", J Emerg Trauma Shock, 3, pp.307~ (2010)
- Thurston TA, "Reversal of a paradoxical reaction to midazolam with flumazenil", Anesth Analg, 83, pp.192~ (1996)
- Piekarski JM, "Benzodiazepine reversal with flumazenil : a review of the literature", J Can Dent Assoc, 58, pp.307~310 (1992)
- Horner G, "Innervation of the human knee joint and implications for surgery", Clin Orthop Relat Res, (301), pp.221~226 (1994)
- Rommel O, "Neuropathic pain following lesions of the infrapatellar branch of the femoral nerve : an important differential diagnosis in anterior knee pain", Schmerz, 23, pp.355~359 (2009)
- Barton RS, "Intraosseous innervation of the human patella : a histologic study", Am J Sports Med, 35, pp.307~311 (2007)
- Moore KL, "Clinically oriented anatomy", pp.529~531 (2009), Lippincott Williams & Wilkins
- Winnie AP, "The inguinal paravascular technic of lumbar plexus anesthesia : the"3-in-1 block"", Anesth Analg, 52, pp.989~996 (1973)
- Chelly JE, "Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty", J Arthroplasty, 16, pp.436~445 (2001)
- Ritter JW, "Femoral nerve"sheath"for inguinal paravascular lumbar plexus block is not found in human cadavers", J Clin Anesth, 7, pp.470~473 (1995)
- Curatolo M, "Failure rate of epidural anaesthesia for foot and ankle surgery : a comparison with other surgical procedures", Eur J Anaesthesiol, 12, pp.363~367 (1995)
- Flaatten H, "Spinal anaesthesia for outpatient surgery", Anaesthesia, 40, pp.1108~1111 (1985)
- Gold BS, "Unanticipated admission to the hospital following ambulatory surgery", JAMA, 262, pp.3008~3010 (1989)
- Kim SC, "Learning curve of medical students in ultrasound-guided simulated nerve block", J Anesth, 28, pp.76~80 (2014)
