RESUMO
OBJECTIVE: Postoperative pain is one of the most frequent complications of outpatient orthopedic surgery. We therefore studied the efficacy, feasibility, and safety of the continuous femoral nerve block as an analgesic technique for outpatient anterior cruciate ligament reconstruction. MATERIAL AND METHODS: We carried out a single-blind prospective study of ASA 1-2 patients who received a continuous femoral nerve block with 0.125% bupivacaine through an elastomeric pump to treat postoperative pain as part of a multimodal approach. Postoperative pain was assessed on a verbal numerical scale from the immediate postoperative period until 48 hours after the operation. Side effects and patient satisfaction were also assessed. RESULTS: Sixty-three patients were enrolled. The continuous femoral nerve block was effective: in the first 24 hours following surgery 90% of patients had mild or no pain, and 92% required no rescue medication. It also proved safe, as there were no significant side effects. CONCLUSION: The continuous femoral nerve block with 0.125% bupivacaine is a safe, effective option for the management of postoperative pain in outpatient anterior cruciate ligament reconstruction.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Ligamento Cruzado Anterior/cirurgia , Bloqueio Nervoso Autônomo/métodos , Bombas de Infusão , Dor Pós-Operatória/tratamento farmacológico , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/uso terapêutico , Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/uso terapêutico , Bloqueio Nervoso Autônomo/instrumentação , Bupivacaína/administração & dosagem , Bupivacaína/uso terapêutico , Quimioterapia Combinada , Elastômeros , Assistência Domiciliar , Humanos , Infusões Intravenosas , Entorpecentes/administração & dosagem , Entorpecentes/uso terapêutico , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Método Simples-Cego , Tramadol/administração & dosagem , Tramadol/uso terapêuticoRESUMO
Peripheral nerve blocks have aroused increasing interest in recent years, leading to a rise in the rate of complications. At the same time noteworthy technical advances have been made in areas such as nerve stimulation and ultrasound imaging, and local anesthetics have become safer. Nevertheless, the risk of anesthetic-related systemic toxicity, which manifests with neurological symptoms that tend to be forerunners of cardiovascular ones, can not be ignored. We report 2 cases of systemic toxicity due to the use of a mixture of local anesthetics during nerve blocks for outpatient surgery.