2017 ISAKOS Biennial Congress ePoster #713

 

Examining The Role Of Perioperative Nerve Blocks In Hip Arthroscopy - A Systematic Review

Jeffrey Kay, MD, Toronto, ON CANADA
Darren L. de SA, MD, FRCSC, Hannon, ON CANADA
Muzammil Memon, MD, Hamilton, ON CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
James Paul, MD, Hamilton, ON CANADA
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA

McMaster University, Hamilton, ON, CANADA

FDA Status Not Applicable

Summary

The use of perioperative nerve blocks provides effective pain management following hip arthroscopy and may be more effective in decreasing acute postoperative pain and supplemental opioid consumption than other analgesic techniques.

Abstract

Introduction

This systematic review examines the efficacy of perioperative nerve blocks for pain control following hip arthroscopy.

Methods

The databases EMBASE, PubMed and Medline were searched on June 2, 2015, for English-language studies that reported on the use of perioperative nerve blocks for hip arthroscopy. The studies were systematically screened and data abstracted in duplicate.

Results

Nine eligible studies were included in this review (two case reports, two case series, three non-randomized comparative studies, and two randomized controlled trials). In total, 534 patients (534 hips) with a mean age of 37.2 years who underwent hip arthroscopy procedures were administered nerve blocks for pain management. Specifically, femoral (two studies), fascia iliaca (two studies), lumbar plexus (three studies) and L1 and L2 paravertebral (two studies) nerve blocks were used. All studies reported acceptable pain scores following the use of nerve blocks and four studies showed significantly lower postoperative pain scores acutely with the use of nerve blocks over general anesthesia alone. The use of nerve blocks also resulted in a decrease in opioid consumption in four studies and provided a higher level of patient satisfaction in two studies. No serious acute complications were reported in any study and long-term complications from lumbar plexus blocks, such as local anesthetic system toxicity (0.9%) and long-term neuropathy (2.8%) were low in incidence.

Conclusion

The use of perioperative nerve blocks provides effective pain management following hip arthroscopy and may be more effective in decreasing acute postoperative pain and supplemental opioid consumption than other analgesic techniques. Future research is needed to compare techniques and develop a standardized approach.