title: Postoperative fall after the use of the 3-in-1 femoral nerve block for knee surgery: a report of four cases.
abstract: We present a serious postoperative complication related to the use of femoral nerve block in 4 patients, each of whom fell and sustained further injury. Preoperatively, all patients underwent a 3-in-1 femoral nerve block with 30 to 35 ml of 0.25% levobupivacaine with 1:200,000 epinephrine, with guidance by a nerve stimulator. After the falls, neurological examination of the operated legs revealed reduced 2-point discrimination, pain, and/or light touch sensation. All patients underwent further operation for the fall injury and had delayed full weight bearing. We recommend that, after having a femoral nerve block, patients should undergo enhanced postoperative evaluation of blockade and proprioceptive function to ensure safe neurological function before mobilisation.
authors.affiliation: Department of Trauma and Orthopaedics, Imperial College School of Medicine, St Mary's Hospital, London, United Kingdom. dusch1@gmail.com
authors.forename: H D E
authors.initials: HD
authors.lastname: Atkinson
authors.forename: I
authors.initials: I
authors.lastname: Hamid
authors.forename: C M
authors.initials: CM
authors.lastname: Gupte
authors.forename: R C
authors.initials: RC
authors.lastname: Russell
authors.forename: J M
authors.initials: JM
authors.lastname: Handy
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D001178:Arthroplasty; D001182:Arthroscopy; D001340:Autonomic Nerve Block; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D011183:Postoperative Complications