[Continuous peripheral nerve block with a catheter placed under ultrasound guidance for analgesia after major orthopedic surgery].

BACKGROUND

This prospective study was conducted to investigate the effects and complications of continuous peripheral nerve blocks after major orthopedic surgery using a catheter placed under ultrasound guidance.

METHODS

We studied 182 adult patients who underwent one of three types of major orthopedic surgery and received peripheral nerve blocks with one or two perineural catheters: continuous femoral nerve block after reconstruction of the anterior cruciate ligament, n=93; continuous femoral with or without sciatic nerve block after total knee arthroplasty, n=39; and continuous brachial plexus block after arthroscopic surgery of the shoulder, n=50. All the patients received additional single peripheral nerve block and/or general anesthesia for surgery. A continuous injection of 0.2-0.25% ropivacaine was started immediately after surgery at a rate of 4-6 ml x hr(-1), with a 3 ml patient-controlled bolus available every 30 min, and lasted for at least 48hr. Pain was evaluated at rest and during movement,

RESULTS

Despite large inter-individual variation, continuous peripheral nerve block produced satisfactory postoperative analgesia without any apparent major complications.

CONCLUSIONS

Peripheral nerve block and catheter placement under ultrasound guidance may help manage postoperative analgesia after orthopedic surgery easily, reliably and safely.