The '3 in 1' lumbar plexus block following anterior cruciate ligament reconstruction with autologous hamstring tendons.
We have reviewed 33 patients undergoing primary reconstruction of the anterior cruciate ligament with a four-strand hamstring graft to assess the analgesic effect of a '3 in 1' lumbar plexus block. Patients were randomised into two groups to determine whether or not they received a catheter infusion of bupivacaine for 24 h after operation. Pain scores and additional analgesic requirements were assessed at 4, 8, 12, 16, 20 and 24 h after surgery. No difference was found between the two groups in terms of pain scores (P=0.884) and the numbers requiring morphine were similar (5/16 and 7/17). There was a trend (2.0 vs. 3.4 tablets) towards a greater coproxamol requirement for the non-block group, although not quite statistically significant (P=0.06). We conclude that the additional risk and cost of '3 in 1' lumbar plexus blockade is not justifiable after this procedure.
O'Leary
ST
Heatherwood and Wexham Park Hospitals Trust, Wexham Park Hospital, Slough, UK
Unwin
A
Smith
BL
Allum
RL