E-ISSN: 1305-9327 ISSN: 1305-9319
Retrospective Investigation of the Efficacy of Blocks for Analgesia in Lower Extremity Surgery
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Research
VOLUME: 15 ISSUE: 4
P: 376-382
December 2019

Retrospective Investigation of the Efficacy of Blocks for Analgesia in Lower Extremity Surgery

Med J Bakirkoy 2019;15(4):376-382
DOI: 10.4274/BTDMJB.galenos.2018.20181207100323
Gökhan Sertçakacılar 1
Yaser Pektaş 1
Halil Çetingök 2
Mehmet Süleyman Sabaz 1
İpek Bostancı 1
Zafer Çukurova 1
Gülsüm Oya Hergünsel 1
1. Sağlık Bilimleri Üniversitesi, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
2. İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
No information available.
No information available
Received Date: 07.12.2018
Accepted Date: 24.12.2018
Publish Date: 20.12.2019
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ABSTRACT

Objective:

The aim of this study was to examine the efficacy of the blocks in the orthopedic lower extremity surgery for analgesia.

Methods:

This retrospective research design was conducted with the Pain and Patient Follow-up Forms, which were registered in a training and research hospital between January 2015 and September 2018. Patients underwent unilateral lower extremity surgery under elective conditions with different clinical diagnoses were included in the study. A total of 58 patients in the 18-80 age group and in the American Society of Anesthesiologists I-II and III risk group who had no missing information in the pain and patient follow-up form were included in the study. Data was collected using the patient and pain follow-up form, Pinprick test and Modified Broomage scale. Kolmogorov Smirnov test, skewness and kurtosis, frequency, percentage, mean and standard deviation, minimum-maximum values, paired t-test used for data analysis.

Results:

The mean age and duration of surgery were significantly higher in patients with femoral + sciatic (FS) block compared to patients who had adductor canal block + sciatic nerve (AKS) block. In addition, there was no statistically significant difference between groups in terms of the return time of pain sensation and sensory block. Also, the mean duration of motor block in FS block group was significantly shorter than AKS block group. There was no statistically significant difference between the groups in terms of hemodynamic data and pain level measured in 0th, 1st, 6th, 12th, 24th, 24th, 30th, 36th, 40th and 48th hours.

Conclusion:

In postoperative analgesia of patients undergoing orthopedic lower extremity surgery, there was no difference between FS block and AKS block groups in terms of the return time of pain sensation and sensory block. The mean duration of motor block in FS block group was significantly shorter than AKS block group. Considering that the return time of pain sensation and return time of sensory block in the selection of regional anesthesia methods, there is no statiscally difference between the FS block and AKS block groups in terms of early ambulation and physiotherapy practises.

Keywords:
Lower extremity, orthopedic surgery, adductor canal block, sciatic nerve block, femoral nerve block

References

1
Almaz S, Ölmez Kavak G, Doğan E, Çelik F, Tokgöz O, Tüfek A., et al. Alt ekstremite cerrahisinde spinal anestezi ve kombine femoral-siyatik sinir bloğunun karşılaştırılması. Journal of Clinical and Experimental Investigations 2014;5:375-9.
2
Özyalçın SN, Erdine S. Üst Ekstremite Somatik Blokları. Rejyonel Anestezi. İstanbul: Nobel Tıp Kitabevi; 2005.
3
Çelik F, Tüfek A, Yıldırım ZB, Tokgöz O, Karaman H, Alemdar C, et al. Üst ekstremite cerrahisinde uygulanan brakial pleksus sinir bloğu deneyimlerimiz. Dicle Tip Dergisi/Dicle Medical Journal 2012;39:31-4.
4
Laurant DBS, Peng P, Arango LG, Niazi AU, Chan VW, Agur A, et al. The nerves of the adductor canal and the innervation of the knee: an anatomic study. Regional Anesthesia and Pain Medicine 2016;41:321-7.
5
Rahimzadeh P, Faiz HR, Imani F., Hobika GG, Abbasi A, Nader ND. (). Relieving pain after arthroscopic knee surgery: Ultrasound-Guided femoral nerve block or adductor canal block?. Turk J Anaesthesiol Reanim 2017;45:218-24.
6
Kim DH, Lin ., Goytizolo EA, Kahn RL, Maalouf DB, Manohar A, et al. Adductor canal block versus femoral nerve block for total knee arthroplastya prospective, randomized, controlled trial. Anesthesiology: The Journal of the American Society of Anesthesiologists 2014;120:540-50.
7
Dahl V, Gierloff C, Omland E, Raeder JC. Spinal, epidural or propofol anaesthesia for outpatient knee arthroscopy? Acta Anaesthesiol Scand 1997;41:1341-5.
8
Auroy Y, Narchi P, Messiah A, Litt L, Rouiver B, Samii K. Serious complications related to regional anesthesia. Anesthesiology 1997;87:479-86.
9
Hadzic A. Periferik Sinir Blokları ve Ultrason Eşliğinde Rejyonal Anestezi için Anatomi. Kurt E, çeviri editörü. 1. Baskı. Ankara: Güneş Tıp Kitabevi 2013;397-433.
10
Tuncer B, Yılmaz D, Günaydın G, Özer E, Sezer GB, Çanakcı N. Ayak ve ayak bileği cerrahisinde periferik sinir blokları. TOTBİD Dergisi 2013;12:83-7.
11
Topçu İ. Alt Ekstremite periferik sinir blokları. Turkiye Klinikleri Journal of Anesthesiology Reanimation Special Topics 2015;8:96-104.
12
Tülübaş EK, Bostancı İ, Sertçakacılar G, Pektaş Y, Edipoğlu E. Comparison of femoral block and adductor canal block in the postoperative analgesia of patients undergoing arthroscopic knee surgery. The European Research Journal 2019;5:473-8.
13
Çelik F, Tüfek A, Yıldırım ZB, Tokgöz O, Karaman H, Alemdar C, et al. Alt ekstremite cerrahisinde uygulanan kombine femoral siyatik sinir bloğu deneyimlerimiz. Journal of Clinical and Experimental Investigations 2011;2:375-9.
14
Memtsoudis SG, Yoo D, Stundner O, Danninger T, Ma Y, Poultsides L, et al. Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement. International Orthopaedics 2015;39:673-80.
15
Adalı S, Erkalp K, Erden V, Çömlekçi M, Bülbül M, Aldemir T. Ortopedik alt ekstremite cerrahisinde spinal anestezi ile kombine siyatik-femoral blok teknikleri. Acta Orthop Traumatol Turc 2011;45:225-32.
16
Tran D, Clemente A, Finlayson RJ. A review of approaches and techniques for lower extremity nerve blocks. Can J Anaesth 2007;54:922-34.