title: Patient satisfaction and effectiveness of lumbar plexus and sciatic nerve block for total knee arthroplasty.
abstract: The purpose of this study was to evaluate the efficacy of combined lumbar plexus block techniques for total knee arthroplasty. Long-acting local anesthetics were used to ensure adequate intraoperative and postoperative anesthesia and analgesia. All patients undergoing total knee arthroplasty at our institution were offered lumbar plexus block after obtaining informed consent. Patients for study were a continuous group of 87 patients over a 1-year period. A subset of 40 patients was studied for postoperative analgesia effect. All patients were contacted by phone for a satisfaction survey. There were 87 patients who received initial lumbar plexus and sciatic nerve blocks, 78% (68 of 87) of whom had adequate initial blocks. Sixteen patients (22%) required conversion to general anesthesia intraoperatively because of inadequate anesthesia. A subset of patients studied for postoperative analgesia revealed an average time of 13 hours before the first request for supplemental narcotics. There were no complications related to the lumbar plexus block in our study group of patients. There was a 92% overall satisfaction rate with the anesthesia provided by the lumbar plexus block. Lumbar plexus block can be used successfully for total knee arthroplasty. Lumbar plexus block appears to have advantages for early postoperative analgesia, leading to increased patient comfort and satisfaction.
authors.affiliation: Division of Orthopaedic Surgery, Box 3000, Trent Drive, Duke University Medical Center, Durham, NC 27705, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Luber
authors.forename: R
authors.initials: R
authors.lastname: Greengrass
authors.forename: T P
authors.initials: TP
authors.lastname: Vail
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain; D017060:Patient Satisfaction; D012584:Sciatic Nerve