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COMBINATION OF REGIONAL ANAESTHESIA (RA) & LOCAL INFILTRATION ANALGESIA (LIA) PROVIDE SUPERIOR ANALGESIA IN ENHANCED RECOVER HIP & KNEE ARTHROPLASTY WITHOUT DELAYING POST OPERATIVE MOBILISATION
ESRA Academy. Bhatti T. Sep 8, 2016; 138526; 0391 Topic: Peripheral Nerve Blocks
Disclosure(s): No conflict of interest
Dr. Tajammal H. Bhatti
Dr. Tajammal H. Bhatti

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Abstract
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Background and Aims:

 Regional anaesthesia techniques are usually avoided in patients undergoing enhanced recovery hip & knee replacement surgeries due to the potential risk of  legs weakness and delay in post operative mobilisation . We evaluated the role of RA techniques, their efficacy and effect on mobilisation in ERP hip & knee replacements

Methods:

10 patients each for ERP hip & knee arthroplasties were included in this comparative study. All patients received low dose spinal anaesthesia for surgery using 3-4 mls of o.25% Levobupivaine. Patients for hip replacement received Quadratus Lumborum block and LIA using 0.125% Levobupicaine & for knee replacement received adductor canal block, ring block of knee (I PACK block) in addition to LIA, using 0.125% Levobupivacaine. Total dose of Levobupivacaine for nerve blocks plus LIA was kept under 2.5mg/kg in both groups. All blocks were performed under ultrasound guidance. LIA was performed intra by the surgeon. Post operative analgesia was similar for all the patients. Post operatively the pain score, need for first dose of analgesia, weakness of legs and time to mobilise were recorded. The results were compared with patients who received LIA only without RA blocks intra operatively. 

Results:

Pain scores, need for first dose of post op analgesia were better in LIA + RA as compared to LIA only. There were no weakness of legs or delay in mobilisation after the surgery in both groups of patients

Conclusions:

Combination of LIA & RA provide superior post op analgesia without delaying mobilisation in patients undergoing ERP hip& knee replacement surgeries

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