title: Impact of regional femoral nerve block during general anesthesia for hip arthoplasty on blood pressure, heart rate and pain control: A randomized controlled study.
abstract: BACKGROUND
  Adequate pain management is essential for preventing hemodynamic instability which can affect the perfusion of vital organs during the perioperative period, particularly in geriatric patients. For hip arthroplasty, peripheral nerve block is frequently used, limiting the adverse effects of opioid and non-opioid analgesics.
  
  
  OBJECTIVE
  The aim was to survey the impact of a supplementary single shot femoral nerve block (FNB) on hemodynamic stability and pain level.
  
  
  METHODS
  After registration at German Clinical Trial Register (DRKS-ID): DRKS00000752. and Ethics Committee approval (University Hospital of Marburg), 80 patients who underwent elective hip surgery were included. Half of them were randomly assigned to receive a FNB followed by general anesthesia; a control group received only general anesthesia as standard procedure (STD). Blood pressure and heart rate were measured and recorded every five minutes during surgery and stay at the postanesthesia care unit (PACU).
  
  
  RESULTS
  Fifty-two patients were included for statistical analysis. The FNB group had significantly lower systolic blood pressures during and after surgery and lower diastolic blood pressure postoperatively, heart rate, as well as opioid and non-steroidal anti-inflammatory consumption.
  
  
  CONCLUSIONS
  Femoral nerve block improved perioperative hemodynamic stability mostly likely attributable to an overall reduced sympathico adrenergic tone.
authors: Department of Anesthesia and Intensive Care Medicine, University Hospital, Philipps-University of Marburg, Marburg, Germany.|Department of Anesthesia and Intensive Care Medicine, Clinique Bénigne Joly, Talant, France.
authors: Thomas
authors: T
authors: Kratz
authors: Department of Anesthesia and Intensive Care Medicine, University Hospital, Johannes Gutenberg University, Mainz, Germany.
authors: Frank
authors: F
authors: Dette
authors: Department of Orthopedics and Rheumatology, University Hospital Marburg, Marburg, Germany.|Department of Orthopedics and Traumatology, Lahn-Dill-Klinikum Wetzlar, Wetzlar, Germany.
authors: Jan
authors: J
authors: Schmitt
authors: Department of Anesthesia and Intensive Care Medicine, University Hospital, Philipps-University of Marburg, Marburg, Germany.
authors: Thomas
authors: T
authors: Wiesmann
authors: Department of Anesthesia and Intensive Care Medicine, University Hospital, Philipps-University of Marburg, Marburg, Germany.
authors: Hinnerk
authors: H
authors: Wulf
authors: Department of Anesthesia and Intensive Care Medicine, University Hospital, Philipps-University of Marburg, Marburg, Germany.
authors: Martin
authors: M
authors: Zoremba
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000768:Anesthesia, General / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D017558:Elective Surgical Procedures; D005260:Female; D005267:Femoral Nerve; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Femoral nerve block; hemodynamic control; hip arthroplasty; postoperative analgesics