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Chen B, Tan M, Li Q, Wang S, Chen D, Zhao M, Cao J. Application of ultrasound-guided single femoral triangle and adductor canal block in arthroscopic knee surgery: a prospective, double-blind, randomized clinical study. BMC Anesthesiol 2024; 24:182. [PMID: 38783177 PMCID: PMC11112763 DOI: 10.1186/s12871-024-02555-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE To compare the difference in analgesic effect between femoral triangle block (FTB) and adductor canal block (ACB) during arthroscopic knee surgery. METHODS Patients who underwent arthroscopic knee surgery were randomized preoperatively to FTB group or ACB group. For each group, 20 mL of 0.1% ropivacaine was injected. PRIMARY OUTCOMES The numeric rating score (NRS) at 12 h after surgery at rest and during movement. SECONDARY OUTCOME (1) The NRS at post anesthesia care unit (PACU) and 2, 24 h after surgery at rest and during movement; (2) The quadriceps muscle strength at PACU and 2, 12, 24 h after surgery; (3) Consumption of Rescue analgesia; (4) Incidence of adverse reactions. RESULTS The NRS at 12 h after surgery at rest and during movement of ACB group were higher than FTB group. Among secondary outcomes, the NRS at PACU at rest and during movement, 2 h after surgery during movement of FTB group lower than ACB group; the quadriceps muscle strength at 2 h after surgery of FTB group stronger than ACB group. After multiple linear regression model analysis, the data showed additional statistically significant reduction NRS at 24 h after surgery at rest (0.757, p = 0.037) in FTB group. Other outcomes were similar between two groups. CONCLUSIONS The FTB appears to provide superior pain control after knee arthroscopy than ACB, the FTB is superior to the ACB in quadriceps muscle strength at 2 h after surgery. TRIAL REGISTRATION The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2300068765). Registration date: 28/02/2023.
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Affiliation(s)
- Baizhou Chen
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Minghe Tan
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Qingshu Li
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Siqi Wang
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Daiyu Chen
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Maoji Zhao
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Jun Cao
- The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
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Kull C, Martin R, Rossel JB, Nguyen A, Albrecht E. Femoral vs sciatic nerve block to provide analgesia after medial open wedge high tibial osteotomy in the setting of multimodal analgesia: A randomized, controlled, single-blinded trial. J Clin Anesth 2024; 93:111355. [PMID: 38134484 DOI: 10.1016/j.jclinane.2023.111355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/14/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
STUDY OBJECTIVE Medial open wedge high tibial osteotomy (MOW HTO) is associated with moderate to severe postoperative pain. The proximal part of the tibia is innervated by branches from the femoral nerve anteriorly and the sciatic nerve posteriorly. There is a paucity of information regarding the optimal peripheral nerve block for postoperative analgesia with minimal impact on motor function. This study tested the hypothesis that a femoral nerve block provides superior analgesia to a sciatic nerve block after MOW HTO in the setting of multimodal analgesia. DESIGN Randomized controlled single-blind trial. SETTING Operating room, postoperative recovery area and ward, up to 6 postoperative months. PATIENTS Fifty patients undergoing MOW HTO. INTERVENTIONS Interventions were femoral or sciatic nerve block under ultrasound guidance. For each intervention, a total of 100 mg of ropivacaine was injected. Postoperative pain treatment followed a pre-defined protocol with intravenous patient-controlled analgesia of morphine, paracetamol, and ibuprofen. MEASUREMENTS The primary outcome was intravenous morphine consumption at 24 h postoperatively. Secondary outcomes included rest and dynamic pain scores (on a numeric rating scale out of 10) at 2, 24 and 48 h postoperatively. Functional outcomes included the Short Form-12, Knee injury and Osteoarthritis Outcome Score, and International Knee Documentation Committee (IKDC) scores measured at 6 months postoperatively. MAIN RESULTS Mean [95% confidence interval] i.v. morphine consumption at 24 postoperative hours were 24 mg [15 mg,33 mg] in the femoral nerve block group and 24 mg [16 mg,32 mg] in the sciatic nerve block group (p = 0.98). There were no significant differences in the secondary outcomes between groups. CONCLUSIONS This trial failed to demonstrate that a femoral nerve block provides superior analgesia to a sciatic nerve block after MOW HTO under general anesthesia in the setting of multimodal analgesia. There was no significant difference in quality of life and functional outcomes at 6 months postoperatively between groups. Trial registry number:Clinicaltrials.com - NCT05728294; Kofam.ch - SNCTP000003048 | BASEC2018-01774.
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Affiliation(s)
- Corey Kull
- Department of Anaesthesia, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Robin Martin
- Consultant, Department of Orthopedic surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Jean-Benoit Rossel
- Statistician, Centre for Primary Care and Public Health (Unisanté), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Alexandre Nguyen
- Research assistant, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Eric Albrecht
- Program director of Regional Anesthesia, Department of Anesthesia, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
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Paulou F, Wegrzyn J, Rossel JB, Gonvers E, Antoniadis A, Kägi M, Wolmarans MR, Lambert J, Albrecht E. Analgesic efficacy of selective tibial nerve block versus partial local infiltration analgesia for posterior pain after total knee arthroplasty: a randomized, controlled, triple-blinded trial. Anaesth Crit Care Pain Med 2023; 42:101223. [PMID: 37030393 DOI: 10.1016/j.accpm.2023.101223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 02/28/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The adductor canal block provides pain relief on the anterior aspect of the knee after arthroplasty. Pain on the posterior aspect may be treated either by partial local infiltration analgesia of the posterior capsule or by a tibial nerve block. This randomized, controlled, triple-blinded trial tests the hypothesis that a tibial nerve block would provide superior analgesia compared to posterior capsule infiltration in patients scheduled for total knee arthroplasty under spinal anesthesia with an adductor canal block. METHODS Sixty patients were randomized to receive either infiltration of the posterior capsule by the surgeon with ropivacaine 0.2%, 25 mL, or a tibial nerve block with 10 mL of ropivacaine 0.5%. Sham injections were performed to guarantee proper blinding. The primary outcome was intravenous morphine consumption at 24 h. Secondary outcomes included intravenous morphine consumption, pain scores at rest and on movement, and different functional outcomes, measured at up to 48 h. When necessary, longitudinal analyses were performed with a mixed-effects linear model. RESULTS The median (interquartile range) of cumulative intravenous morphine consumption at 24 h was 12 mg (4-16) and 8 mg (2-14) in patients having the infiltration or the tibial nerve block respectively (p = 0.20). Our longitudinal model showed a significant interaction between group and time in favor of the tibial nerve block (p = 0.015). No significant differences were present between groups in the other above-mentioned secondary outcomes. CONCLUSION A tibial nerve block does not provide superior analgesia when compared to infiltration. However, a tibial nerve block might be associated with a slower increase in morphine consumption over time.
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Affiliation(s)
- F Paulou
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J Wegrzyn
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J B Rossel
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - E Gonvers
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - A Antoniadis
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Kägi
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M R Wolmarans
- Department of Anaesthesia, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - J Lambert
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - E Albrecht
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
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Beletsky A, Currie M, Shen J, Maan R, Desilva M, Winston N, Gabriel RA. Association of patient characteristics with the receipt of regional anesthesia. Reg Anesth Pain Med 2023; 48:217-223. [PMID: 36635043 DOI: 10.1136/rapm-2022-103916] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Regional anesthesia (RA) may improve patient-related outcomes, including decreased operative complications, shortened recovery times, and lower hospital readmission rates. More analyses are needed using a diverse set of databases to examine characteristics associated with the receipt of RA. METHODS A national hospital database was queried for patients 18 years or older who underwent total shoulder arthroplasty (TSA), total knee arthroplasty (TKA), anterior cruciate ligament reconstruction (ACLR), carpal tunnel release, ankle open reduction, and internal fixation and arteriovenous fistula creation between January 2016 and June 2021. Regional techniques included neuraxial anesthesia and various upper and lower extremity peripheral nerve blocks to create a binary variable of RA receipt. Univariate statistics were used to compare characteristics associated based on RA receipt and multivariable regression identified factors associated with RA receipt. RESULTS A total of 51 776 patients were included in the analysis, of which 2111 (4.1%) received RA. Factors associated with decreased odds of RA receipt included black race (vs white race; OR 0.73, 95% CI 0.62 to 0.86), other non-white race (vs white race; OR 0.71, 95% CI 0.61 to 0.86), American Society of Anesthesiologists (ASA) class (vs ASA 1; OR 0.85, 95% CI 0.79 to 0.93), and Medicaid insurance (vs private insurance; OR 0.65, 95% CI 0.51 to 0.82) (all p<0.05). When compared with TKA, ACLR (OR 0.67, 95% CI 0.53 to 0.84), ankle open reduction and internal fixation (OR 0.68, 95% CI 0.58 to 0.81), and carpal tunnel release (OR 0.68, 95% CI 0.59 to 0.78) demonstrated lower odds of RA receipt, whereas TSA (OR 1.31, 95% CI 1.08 to 1.58) demonstrated higher odds of RA receipt (all p<0.05). CONCLUSION RA use varies with respect to race, insurance status, and type of surgery.
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Affiliation(s)
- Alexander Beletsky
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Morgan Currie
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Jonathan Shen
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Ramneek Maan
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Mahesh Desilva
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Nutan Winston
- Anesthesiology, Riverside Community Hospital, Riverside, California, USA
| | - Rodney A Gabriel
- Anesthesiology, University of California San Diego, La Jolla, California, USA
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Xie Y, Sun Y, Lu Y. Effect of Adductor Canal Block Combined with Local Infiltration Analgesia on Postoperative Pain of Knee Arthroscopy Under General Anesthesia: A Randomized Controlled Trial. Pain Ther 2023; 12:543-552. [PMID: 36790542 PMCID: PMC10036701 DOI: 10.1007/s40122-023-00482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Postoperative pain in knee arthroscopy (KA) is a common and troublesome problem. The best local analgesic technique for relieving postoperative pain in patients with KA has not been well studied. This prospective trial aimed to observe whether adductor canal block (ACB) combined with local infiltration analgesia (LIA) could further decrease the incidence of postoperative pain undergoing KA. METHODS This randomized controlled study recruited 60 patients aged 18-65 years, ASA I-II, who received KA, and randomly divided them into ACB + LIA group and LIA group. The primary outcome was the incidence of postoperative pain 24 h after surgery. The secondary outcomes included the incidence of quadriceps femoris weakness, and the consumption of opioids during operation. RESULTS A total of 60 participants completed the trial. The incidence of postoperative pain 24 h after surgery in ACB + LIA group was lower than that in the LIA group (10% [3 of 30] vs. 33% [10 of 30]; P = 0.028). There was no difference in the incidence of quadriceps muscle weakness 24 h after surgery between the two groups. The consumption of remifentanil and sufentanil in ACB + LIA group was significantly lower than that in LIA group (P = 0.006, P < 0.001). CONCLUSIONS Compared with patients receiving LIA alone, ACB combined with LIA could reduce the incidence of postoperative pain while retaining the strength of the quadriceps femoris in patients undergoing KA and reduce the consumption of opioids during surgery. CLINICAL TRIAL NUMBER AND REGISTRY URL This study was registered at the Chinese Clinical Trial Registry with the registration number ChiCTR1800018463 on September 20, 2018. ( http://www.chictr.org.cn/showproj.aspx?proj=31192 ).
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Affiliation(s)
- Yaping Xie
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, China
| | - Yue Sun
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, China
| | - Yao Lu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, China.
- Ambulatory Surgery Center, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
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Hussain N, Brull R, Vannabouathong C, Speer J, Lagnese C, McCartney CJL, Abdallah FW. Network meta-analysis of the analgesic effectiveness of regional anaesthesia techniques for anterior cruciate ligament reconstruction. Anaesthesia 2023; 78:207-224. [PMID: 36326047 DOI: 10.1111/anae.15873] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
Anterior cruciate ligament reconstruction can cause moderate to severe acute postoperative pain. Despite advances in our understanding of knee innervation, consensus regarding the most effective regional anaesthesia techniques for this surgical population is lacking. This network meta-analysis compared effectiveness of regional anaesthesia techniques used to provide analgesia for anterior cruciate ligament reconstruction. Randomised trials examining regional anaesthesia techniques for analgesia following anterior cruciate ligament reconstruction were sought. The primary outcome was opioid consumption during the first 24 h postoperatively. Secondary outcomes were: rest pain at 0, 6, 12 and 24 h; area under the curve of pain over 24 h; and opioid-related adverse effects and functional recovery. Network meta-analysis was conducted using a frequentist approach. A total of 57 trials (4069 patients) investigating femoral nerve block, sciatic nerve block, adductor canal block, local anaesthetic infiltration, graft-donor site infiltration and systemic analgesia alone (control) were included. For opioid consumption, all regional anaesthesia techniques were superior to systemic analgesia alone, but differences between regional techniques were not significant. Single-injection femoral nerve block combined with sciatic nerve block had the highest p value probability for reducing postoperative opioid consumption and area under the curve for pain severity over 24 h (78% and 90%, respectively). Continuous femoral nerve block had the highest probability (87%) of reducing opioid-related adverse effects, while local infiltration analgesia had the highest probability (88%) of optimising functional recovery. In contrast, systemic analgesia, local infiltration analgesia and adductor canal block were each poor performers across all analgesic outcomes. Regional anaesthesia techniques that target both the femoral and sciatic nerve distributions, namely a combination of single-injection nerve blocks, provide the most consistent analgesic benefits for anterior cruciate ligament reconstruction compared with all other techniques but will most likely impair postoperative function. Importantly, adductor canal block, local infiltration analgesia and systemic analgesia alone each perform poorly for acute pain management following anterior cruciate ligament reconstruction.
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Affiliation(s)
- N Hussain
- Department of Anesthesiology, Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - R Brull
- Department of Anesthesiology and Pain Medicine, Women's College Hospital, University of Toronto, ON, Canada
| | - C Vannabouathong
- Department of Anesthesiology, Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - J Speer
- Department of Anesthesiology, Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - C Lagnese
- Department of Anesthesiology, Cleveland Clinic Akron General, Akron, OH, USA
| | - C J L McCartney
- Department of Anesthesiology and Pain Medicine, and the Ottawa Hospital Research Institute, University of Ottawa, ON, Canada
| | - F W Abdallah
- Department of Anesthesiology and Pain Medicine, and the Ottawa Hospital Research Institute, University of Ottawa, ON, Canada.,Department of Anesthesia, and the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, ON, Canada
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Le plexus lombal et ses branches. ANESTHÉSIE & RÉANIMATION 2023. [DOI: 10.1016/j.anrea.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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De Lamo-Rovira J, López-Caba F, Giménez-Giménez J, Szczepan W, Quijada-Rodriguez JL, Solera-Martínez M. Periarticular injection and hamstring block versus placebo for pain control in anterior cruciate ligament reconstruction: A randomized controlled trial. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2022:10.1007/s00590-022-03357-1. [PMID: 35984519 DOI: 10.1007/s00590-022-03357-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To study the effectiveness of periarticular infiltration (PI), including the proximal donor site vs. placebo in anterior cruciate ligament (ACL) reconstruction. METHOD A total of 44 patients were randomized in two groups assigned to receive PI or placebo. The perioperative protocol was the same for both groups. The principal outcome was pain measured at 8 and 24 h by a visual analog scale (VAS). The pain was registered in the knee and the proximal donor site. Pain scores were also assessed to determine whether the VAS improvement would reach the threshold values reported for the minimal clinically significant difference. The secondary outcome was the need for opioid rescue medication. RESULTS Patients receiving PI exhibited lower pain values in the knee at 8 h (mean PI 35.00 ± 5.76 vs. placebo 60.23 ± 4.52 p = 0.01) and at 24 h (mean PI 37.23 ± 5.62 vs. placebo 55.55 ± 3.41 p = 0.008). These results were above the threshold for clinical significance. No improvements were found in proximal donor site pain and consumption of opioid rescue medication. Complications were comparable between the two groups. CONCLUSION PI significantly reduced pain in the knee vs. placebo after ACL reconstruction with hamstring autograft at 8 and 24 h after surgery. The instillation of part of the mixture in the proximal hamstring stump did not result in any improvement LEVEL OF EVIDENCE I: Level I, randomized controlled trial.
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Affiliation(s)
- Joaquín De Lamo-Rovira
- Department of Orthopaedics, Virgen de La Luz Hospital, Hermandad Donantes de Sangre street, 16004, Cuenca, Spain.
| | - Francisco López-Caba
- Department of Orthopaedics, Virgen de La Luz Hospital, Hermandad Donantes de Sangre street, 16004, Cuenca, Spain
| | - Juan Giménez-Giménez
- Department of Orthopaedics, Virgen de La Luz Hospital, Hermandad Donantes de Sangre street, 16004, Cuenca, Spain
| | - Witold Szczepan
- Department of Orthopaedics, Virgen de La Luz Hospital, Hermandad Donantes de Sangre street, 16004, Cuenca, Spain
| | - Jose Luis Quijada-Rodriguez
- Department of Orthopaedics, Virgen de La Luz Hospital, Hermandad Donantes de Sangre street, 16004, Cuenca, Spain
| | - Montserrat Solera-Martínez
- Health and Social Research Center and Faculty of Nursing, Universidad de Castilla-La Mancha, Edificio Melchor Cano. Santa Teresa Jornet S/N, Cuenca, Spain
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Bhakta P, Dasgupta K, Chaudhry S, O'Brien B. Combining femoral triangle block with infiltration between the popliteal artery and capsule of the posterior knee in anterior cruciate ligament reconstruction. Reg Anesth Pain Med 2021; 47:197. [PMID: 34493622 DOI: 10.1136/rapm-2021-103060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Pradipta Bhakta
- Department of Anaesthesia and Intensive Care, University Hospital Waterford, Waterford, Ireland
| | - Kausik Dasgupta
- Department of Anaesthesiology and Intensive Care, George Eliot Hospital NHS Trust, Nuneaton, UK
| | - Shirjeel Chaudhry
- Department of Anaesthesiology and Intensive Care, George Eliot Hospital NHS Trust, Nuneaton, UK
| | - Brian O'Brien
- Department of Anaesthesiology and Intensive Care, Cork University Hospital, Cork, Ireland
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Albrecht E, Martin R, Kirkham K. Response to comment on: the combination of femoral triangle block and infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) versus local infiltration analgesia for analgesia after anterior cruciate ligament reconstruction: a randomized, controlled, triple-blinded trial. Reg Anesth Pain Med 2021; 47:197-198. [PMID: 34493625 DOI: 10.1136/rapm-2021-103132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Eric Albrecht
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Robin Martin
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Kyle Kirkham
- Department of Anesthesia, Toronto Western Hospital & University of Toronto, Toronto, Ontario, Canada
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Schwenk ES, Gupta RK. Femoral triangle block plus iPACK block versus local infiltration analgesia for anterior cruciate ligament reconstruction: an infographic. Reg Anesth Pain Med 2021; 47:64. [PMID: 34145055 DOI: 10.1136/rapm-2021-102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Eric S Schwenk
- Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Rajnish K Gupta
- Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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