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SENSORY DISTRIBUTION OF LATERAL FEMORAL CUTANEOUS NERVE BLOCK – A RANDOMIZED, BLINDED, PAIRED TRIAL IN HEALTHY VOLUNTEERS
Author(s): ,
Nersesjan, M.*
Affiliations:
Næstved Hospital, Anesthesiology, Næstved, Denmark
,
Hägi-Pedersen, D.
Affiliations:
Næstved Hospital, Anesthesiology, Næstved, Denmark
,
Andersen, J.H.
Affiliations:
Zealand University Hospital, Anesthesiology, Køge, Denmark
,
Mathiesen, O.
Affiliations:
Zealand University Hospital, Anesthesiology, Køge, Denmark
,
Dahl, J.B.
Affiliations:
Bispebjerg Hospital, Anesthesiology, Copenhagen, Denmark
,
Broeng, L.
Affiliations:
Zealand University Hospital, Orthopedics, Køge, Denmark
Thybo, K.H.
Affiliations:
Næstved Hospital, Anesthesiology, Næstved, Denmark
ESRA Academy. Nersesjan M. Sep 13, 2017; 190887; 187 Topic: Anatomy
Ms. Mariam Nersesjan
Ms. Mariam Nersesjan

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Abstract
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Background and Aims:

The lateral femoral cutaneous nerve (LFCN)-block may be used for postoperative pain management in patients undergoing total hip arthroplasty (THA). The aim of this study was to investigate the distribution area of the LFCN-block in relation to the posterior and anterolateral THA incision lines, and the affection of the femoral nerve.

Methods:

The study was a randomized, paired, blinded trial in twenty healthy volunteers. All subjects received a bilateral LFCN-block randomized to 8 ml ropivacaine on the right side and 8 ml saline on the left side, or vice versa. An orthopedic surgeon depicted the incision lines (invisible for 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 pin-prick test before unblinding the incision lines. Pain during tonic heat stimulation and affection of the femoral nerve by measuring quadriceps strength were assessed.

Results:

The median difference in block coverage of the posterior (primary outcome) and the anterolateral incision lines tested with temperature discrimination were 0.0 % (95 % CI: 0.0-2.3, p=0.109) and 16.5 % (95 % CI: 0.0-24.0, p=0.008) respectively, comparing the active and placebo side. A varying anatomic distribution area was observed. No clinically significant differences for experimental pain and quadriceps muscle strength were found. The non-responder rate was 15 %.

Conclusions:

LFCN-block consisting of 8 ml 0.75 % ropivacaine has limited coverage of the posterior and anterolateral incision lines due to a varying anatomical distribution area.

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