title: [Peripheral blocks for the lower limb: lumbar plexus].
abstract: BACKGROUND
  The techniques of continuous peripheral blockades have shown to be efficient in postoperative pain control, in the various orthopaedic procedures of the limbs. The aim of this study is to evaluate the existing data about the use of a continuous blockade of the lumbar plexus or femoral nerve, together with the indications for technique and therapy.
  
  
  METHODS
  We considered the principal results of prospective, randomised studies described in literature about the assessment of a continuous peripheral blockade of the lumbar plexus or the femoral nerve in limb surgery. Furthermore we described the principal techniques for positioning the perinerval catheters in the considered sites, and the advised dosage regimen.
  
  
  RESULTS
  The various studies report an adequate costs/benefits relation concerning the used techniques. The analysed studies not only report an adequate efficacy of the postoperative pain control, but often show an important benefit in terms of functional recovery of the operated limbs and on final outcome of the patient.
  
  
  CONCLUSIONS
  The use of continuous blockades of the lumbar plexus or femoral nerve shows to be an important and effective instrument not only in terms of positive effects on postoperative pain control, but also in terms of relevant advantages concerning final outcome after surgery. Nevertheless these techniques should not be considered as the only approach to postoperative pain in the orthopaedic patient, but have to be included in a global, multidisciplinary and multimodal approach.
authors.affiliation: Università Vita e Salute, Dipartimento di Anestesiologia, IRCCS H. San Raffaele, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Casati
authors.forename: J E
authors.initials: JE
authors.lastname: Chelly
authors.forename: G
authors.initials: G
authors.lastname: Fanelli
authors.forename: B
authors.initials: B
authors.lastname: Borghi
authors.forename: P
authors.initials: P
authors.lastname: Grossi
authors.forename: L
authors.initials: L
authors.lastname: Bertini
authors.forename: M
authors.initials: M
authors.lastname: Berti
mesh_terms: D006801:Humans; D007866:Leg / Q000601:surgery*; D008160:Lumbosacral Plexus / Q000033:anatomy & histology*; D009407:Nerve Block / Q000379:methods*; D019637:Orthopedic Procedures; D013997:Time Factors
vernacular_title: Blocchi periferici per l'arto inferiore: il plesso lombare.