Ambulatory continuous posterior lumbar plexus blocks following hip arthroscopy: a review of 213 cases

作者：Nye Zachary B^*; Horn Jean Louis; Crittenden Walter; Abrahams Matthew S; Aziz Michael F

来源：Journal of Clinical Anesthesia, 2013, 25(4): 268-274.

DOI：10.1016/j.jclinane.2012.11.013

• Continuous peripheral nerve block
• Hip arthroscopy
• Local anesthetic systemic toxicity
• Lumbar plexus
• Psoas compartment

Study Objective: To evaluate complications associated with ambulatory continuous lumbar plexus blocks. %26lt;br%26gt;Design: Retrospective review of all patients who received a continuous lumbar plexus block for analgesia following arthroscopic hip surgery from January 2004 to July 2009. %26lt;br%26gt;Setting: Academic medical center. %26lt;br%26gt;Measurements: Data from 213 patients who were discharged home with a continuous lumbar plexus block following hip arthroscopy were studied. Side effects and complications, including impaired ambulation, systemic local anesthetic toxicity, abnormal local anesthetic spread, and neurologic injury, were recorded. %26lt;br%26gt;Main Results: Of the 281 patients who received a continuous lumbar plexus block following hip arthroscopy, 213 were discharged home with the continuous lumbar plexus block. Significant complications occurred in 3.8% of patients (8/213). Twenty of 213 patients (9.4%) reported prolonged sensory or motor deficits after the continuous lumbar plexus block was removed. Most of these deficits were minor and resolved spontaneously, but 4 patients (1.9%) experienced persistent neurologic symptoms. One patient had a fall, one patient was readmitted for possible bilateral spread from the continuous lumbar plexus block, and two patients experienced symptoms of local anesthetic systemic toxicity (LAST). %26lt;br%26gt;Conclusions: While complications associated with hip arthroscopy with ambulatory continuous lumbar plexus blocks do occur, significant complications are uncommon. Most complications are managed easily on an outpatient basis. However, nearly 1% of patients presented with symptoms concerning for LAST and were treated without any hemodynamic compromise. Published by Elsevier Inc.

• 出版日期2013-6