title: The 'three in one' block as locoregional analgesia in an emergency department.
abstract: The 'three in one' block is a well-known locoregional technique for per- and post-operative anaesthesia. This 'three in one' block was investigated in an emergency department with three combinations of local anaesthetics as a locoregional way of pain relief for patients with fractures of the upper femur. A double-blind prospective study was conducted with 61 consecutive patients. A good regression of the linear visual analogue scale (LVAS), good haemodynamic stability and great patient satisfaction were found for all groups of patients at different times after installation of the block. Side effects were few and are avoidable by reducing the amount of local anaesthetic given to elderly patients with a low bodyweight. The technique failed in only four patients due to technical reasons. It was concluded that the 'three in one' block is a fast, safe, reliable and easy technique for pain relief in an emergency department. Good analgesia was achieved for patients with fractures of the upper femur with no need to change the position of the patient.
authors.affiliation: Emergency Department, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: F L
authors.initials: FL
authors.lastname: Van Leeuwen
authors.forename: K
authors.initials: K
authors.lastname: Bronselaer
authors.forename: M
authors.initials: M
authors.lastname: Gilles
authors.forename: M B
authors.initials: MB
authors.lastname: Sabbe
authors.forename: H H
authors.initials: HH
authors.lastname: Delooz
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D004638:Emergency Treatment / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005264:Femoral Fractures / Q000150:complications*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008160:Lumbosacral Plexus; D008297:Male; D008619:Mepivacaine / Q000627:therapeutic use*; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D008012:Lidocaine; D008619:Mepivacaine; D002045:Bupivacaine