Bareka Metaxia, Ntalouka Maria P, Angelis Fragkiskos, Mermiri Maria, Tsiaka Aikaterini, Hantes Michael, Arnaoutoglou Eleni
Department of Anaesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110 Larissa, Greece.
Department of Orthopaedic Surgery and Musculoskelatal Trauma, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110 Larissa, Greece.
J Clin Med. 2024 Feb 13;13(4):1054. doi: 10.3390/jcm13041054.
Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. Peripheral nerve blockade as an anesthetic technique is an appealing option in the era of modern anesthesia. The aim of this narrative review is to document the efficacy and safety of the combination of femoral, obturator, and sciatic (FOS) nerve blocks as an exclusive method for anesthesia in patients undergoing ACL reconstruction. An electronic search of the literature published up to October 2023 was conducted in the Medline, Embase, Cochrane, Web of Science, and Google Scholar databases to find studies on ACL reconstruction and peripheral obturator nerve block. Overall, 8 prospective studies-with a total of 315 patients-published between 2007 and 2022 were included in this review. Ultrasound-guided peripheral FOS nerve blockade is an effective anesthetic technique for ACL reconstruction, offering good perioperative pain management, minimal opioid consumption, and an excellent safety profile. Further well-designed prospective studies are needed to determine the best approach for obturator nerve blockade and the appropriate type and dosage of local anesthetic.
采用腘绳肌移植的关节镜下前交叉韧带（ACL）重建术是一种常见的骨科手术，术后会伴有中重度疼痛。在现代麻醉时代，外周神经阻滞作为一种麻醉技术是一个有吸引力的选择。本叙述性综述的目的是记录股神经、闭孔神经和坐骨神经（FOS）联合阻滞作为ACL重建患者唯一麻醉方法的有效性和安全性。在Medline、Embase、Cochrane、科学引文索引和谷歌学术数据库中对截至2023年10月发表的文献进行了电子检索，以查找关于ACL重建和外周闭孔神经阻滞的研究。本综述共纳入了2007年至2022年间发表的8项前瞻性研究，共计315例患者。超声引导下外周FOS神经阻滞是一种用于ACL重建的有效麻醉技术，能提供良好的围手术期疼痛管理，减少阿片类药物的使用，且安全性良好。需要进一步设计良好的前瞻性研究来确定闭孔神经阻滞的最佳方法以及局部麻醉剂的合适类型和剂量。
