A Virginia Mason study has determined that a nerve block technique which avoids the femoral nerve results in the need for less morphine and a potentially speedier recovery for orthopedic surgery patients. The study is the focus of an article in the June edition of Anesthesia & Analgesia, the publication of the International Anesthesia Research Society.
The study involved 80 total knee replacement patients. It concluded that infusing pain-control medication through a catheter in the adductor canal of the mid-thigh -- rather than higher up near the femoral nerve -- provides better pain control and prevents temporary weakness of the leg muscles. This allows recovering patients to walk sooner with stronger legs, resulting in improved physical therapy participation. Patients in the study also needed less morphine to control post-surgery pain.
Virginia Mason anesthesiologists Neil Hanson, MD, and David Auyong, MD, were members of the research team and co-authors of the article. "No one in the world has shown all these possible outcomes in the same study with the adductor canal technique," Dr. Hanson said.
Dr. Auyong added, "Use of the adductor canal for pain-block infusion appears to improve safety and clinical outcomes, and reduces the length of time needed for hospitalization. All patients now get this nerve block at Virginia Mason as part of our standard work for knee replacement surgery."
- Neil A. Hanson, Cindy Jo Allen, Lucy S. Hostetter, Ryan Nagy, Ryan E. Derby, April E. Slee, Alex Arslan, David B. Auyong. Continuous Ultrasound-Guided Adductor Canal Block for Total Knee Arthroplasty. Anesthesia & Analgesia, 2014; 118 (6): 1370 DOI: 10.1213/ANE.0000000000000197
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