Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial

M. Nersesjan*, D. Hägi-Pedersen, J. H. Andersen, O. Mathiesen, J. B. Dahl, L. Broeng, K. H. Thybo

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. Methods: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa. An orthopaedic surgeon depicted the incision lines (invisible to the investigators) prior to block performance. The distribution of the blocked area and the coverage of the incision lines were assessed with temperature discrimination and pinprick test before unblinding the incision lines. Pain during tonic heat stimulation and involvement of the femoral nerve by measuring quadriceps strength were assessed. Results: The mean difference in block coverage of the posterior (primary outcome) and the lateral incision lines tested with temperature discrimination were 5.8% (95% CI: −2.2 to 14.0%, P = 0.146) and 18.9% (95% CI: 6.5–31.4%, P = 0.005), respectively, comparing the active with the placebo side. A varying anatomic distribution area was observed. No clinically significant differences for experimental pain and quadriceps muscle strength were found. The block failure rate was 15%. Conclusion: An LFCN block consisting of 8 ml 0.75% ropivacaine had limited coverage of the posterior and lateral incision lines.

OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind62
Udgave nummer6
Sider (fra-til)863-873
ISSN0001-5172
DOI
StatusUdgivet - 21. jul. 2018

Fingeraftryk

Femoral Nerve
Skin
Quadriceps Muscle
Pain Management
Hip
Placebos
Research Personnel

Citer dette

Nersesjan, M. ; Hägi-Pedersen, D. ; Andersen, J. H. ; Mathiesen, O. ; Dahl, J. B. ; Broeng, L. ; Thybo, K. H. / Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial. I: Acta Anaesthesiologica Scandinavica. 2018 ; Bind 62, Nr. 6. s. 863-873.
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title = "Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial",
abstract = "Background: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. Methods: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa. An orthopaedic surgeon depicted the incision lines (invisible to the investigators) prior to block performance. The distribution of the blocked area and the coverage of the incision lines were assessed with temperature discrimination and pinprick test before unblinding the incision lines. Pain during tonic heat stimulation and involvement of the femoral nerve by measuring quadriceps strength were assessed. Results: The mean difference in block coverage of the posterior (primary outcome) and the lateral incision lines tested with temperature discrimination were 5.8{\%} (95{\%} CI: −2.2 to 14.0{\%}, P = 0.146) and 18.9{\%} (95{\%} CI: 6.5–31.4{\%}, P = 0.005), respectively, comparing the active with the placebo side. A varying anatomic distribution area was observed. No clinically significant differences for experimental pain and quadriceps muscle strength were found. The block failure rate was 15{\%}. Conclusion: An LFCN block consisting of 8 ml 0.75{\%} ropivacaine had limited coverage of the posterior and lateral incision lines.",
keywords = "Adult, Arthroplasty, Replacement, Hip, Female, Femoral Nerve/physiology, Humans, Male, Muscle Strength, Nerve Block/methods, Sensation",
author = "M. Nersesjan and D. H{\"a}gi-Pedersen and Andersen, {J. H.} and O. Mathiesen and Dahl, {J. B.} and L. Broeng and Thybo, {K. H.}",
year = "2018",
month = "7",
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doi = "10.1111/aas.13091",
language = "English",
volume = "62",
pages = "863--873",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
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Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial. / Nersesjan, M.; Hägi-Pedersen, D.; Andersen, J. H.; Mathiesen, O.; Dahl, J. B.; Broeng, L.; Thybo, K. H.

I: Acta Anaesthesiologica Scandinavica, Bind 62, Nr. 6, 21.07.2018, s. 863-873.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial

AU - Nersesjan, M.

AU - Hägi-Pedersen, D.

AU - Andersen, J. H.

AU - Mathiesen, O.

AU - Dahl, J. B.

AU - Broeng, L.

AU - Thybo, K. H.

PY - 2018/7/21

Y1 - 2018/7/21

N2 - Background: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. Methods: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa. An orthopaedic surgeon depicted the incision lines (invisible to the investigators) prior to block performance. The distribution of the blocked area and the coverage of the incision lines were assessed with temperature discrimination and pinprick test before unblinding the incision lines. Pain during tonic heat stimulation and involvement of the femoral nerve by measuring quadriceps strength were assessed. Results: The mean difference in block coverage of the posterior (primary outcome) and the lateral incision lines tested with temperature discrimination were 5.8% (95% CI: −2.2 to 14.0%, P = 0.146) and 18.9% (95% CI: 6.5–31.4%, P = 0.005), respectively, comparing the active with the placebo side. A varying anatomic distribution area was observed. No clinically significant differences for experimental pain and quadriceps muscle strength were found. The block failure rate was 15%. Conclusion: An LFCN block consisting of 8 ml 0.75% ropivacaine had limited coverage of the posterior and lateral incision lines.

AB - Background: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. Methods: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa. An orthopaedic surgeon depicted the incision lines (invisible to the investigators) prior to block performance. The distribution of the blocked area and the coverage of the incision lines were assessed with temperature discrimination and pinprick test before unblinding the incision lines. Pain during tonic heat stimulation and involvement of the femoral nerve by measuring quadriceps strength were assessed. Results: The mean difference in block coverage of the posterior (primary outcome) and the lateral incision lines tested with temperature discrimination were 5.8% (95% CI: −2.2 to 14.0%, P = 0.146) and 18.9% (95% CI: 6.5–31.4%, P = 0.005), respectively, comparing the active with the placebo side. A varying anatomic distribution area was observed. No clinically significant differences for experimental pain and quadriceps muscle strength were found. The block failure rate was 15%. Conclusion: An LFCN block consisting of 8 ml 0.75% ropivacaine had limited coverage of the posterior and lateral incision lines.

KW - Adult

KW - Arthroplasty, Replacement, Hip

KW - Female

KW - Femoral Nerve/physiology

KW - Humans

KW - Male

KW - Muscle Strength

KW - Nerve Block/methods

KW - Sensation

U2 - 10.1111/aas.13091

DO - 10.1111/aas.13091

M3 - Journal article

C2 - 29468642

VL - 62

SP - 863

EP - 873

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 6

ER -