The analgesic effects of proximal, distal, or no sciatic nerve block on posterior knee pain after total knee arthroplasty: a double-blind placebo-controlled randomized trial.

Background: The analgesic efficacy of sciatic nerve block (SNB) after total knee arthroplasty (TKA) is unclear. Proximal and distal SNB are each reported to provide posterior knee analgesia, whereas others suggest that posterior knee pain is not important after TKA. This prospective, randomized, double-blind, parallel-arm, placebo-controlled trial examined whether proximal or distal SNB provides superior analgesia in the posterior knee compared with no SNB after TKA.

The addition of epidural local anesthetic to systemic multimodal analgesia following lumbar spinal fusion: a randomized controlled trial.

Purpose: This randomized trial aimed to evaluate the effects of adding continuous epidural analgesia with a bupivacaine and hydromorphone solution to systemic multimodal analgesia following one- or two-level lumbar spinal fusion.

Methods: Thirty-nine patients undergoing lumbar spinal fusion, stratified for sex and one- or two-level fusion, were randomized to receive a continuous postoperative epidural infusion of either 0.1% bupivacaine with 15 μg·mL(-1) hydromorphone (LA group) or 0.

Ultrasound-guided sciatic nerve block in overweight and obese patients: a randomized comparison of performance time between the infragluteal and subgluteal space techniques.

Background And Objectives: Despite ultrasound (US) guidance, sciatic nerve block (SNB) remains among the least performed peripheral blocks. By targeting the tissue plane between the gluteus maximus and quadratus femoris muscles, the US-guided subgluteal space technique may facilitate the performance of US-guided SNB. We aimed to evaluate whether the subgluteal space technique shortens SNB performance time in overweight and obese patients compared with the conventional infragluteal technique.

Single-injection or continuous femoral nerve block for total knee arthroplasty?

Background: The ideal local anesthetic regime for femoral nerve block that balances analgesia with mobility after total knee arthroplasty (TKA) remains undefined.

Questions/purposes: We compared two volumes and concentrations of a fixed dose of ropivacaine for continuous femoral nerve block after TKA to a single injection femoral nerve block with ropivacaine to determine (1) time to discharge readiness; (2) early pain scores and analgesic consumption; and (3) functional outcomes, including range of motion and WOMAC scores at the time of recovery.

Methods: Ninety-nine patients were allocated to one of three continuous femoral nerve block groups for this randomized, placebo-controlled, double-blind trial: a high concentration group (ropivacaine 0.

Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks.

Background: Poor surface anatomic landmarks are highly predictive of technical difficulty in neuraxial blockade. The authors examined the use of ultrasound imaging to reduce this difficulty.

Methods: The authors recruited 120 orthopedic patients with one of the following: body mass index more than 35 kg/m² and poorly palpable spinous processes; moderate to severe lumbar scoliosis; or previous lumbar spine surgery.

Is circumferential injection advantageous for ultrasound-guided popliteal sciatic nerve block?: A proof-of-concept study.

Background: Ultrasound (US) guidance, in some instances, can increase the success rate and reduce the onset and procedure times for peripheral nerve blockade compared with traditional nerve localization techniques. The presumptive mechanism for these benefits is the ability to accurately inject local anesthetic circumferentially around the target nerve. We aimed to determine whether ensuring circumferential spread of local anesthetic is advantageous for US-guided popliteal sciatic nerve block.