Ambulatory surgery for multi-ligament knee reconstruction with continuous dual catheter peripheral nerve blockade.

Published

Journal Article

PURPOSE: Major reconstructive surgery of the knee traditionally requires an extended hospital stay for pain management. Continuous peripheral nerve blockade is an alternative method of pain control but is seldom used in the ambulatory setting. This case illustrates the use of lumbar plexus and sciatic nerve peripheral catheters for major knee surgery using intermittent bolus dosing for outpatient analgesia. CLINICAL FEATURES: A 20-yr-old male presented for multi-ligamentous knee reconstruction (posterior collateral ligament and revision anterior collateral ligament and lateral collateral ligament). Anesthesia was managed with a lumbar plexus and a sciatic nerve peripheral catheter and a light general anesthetic. Post-operative analgesia was provided with a 12-hr infusion of 0.2% ropivacaine in an over night recovery care centre. Subsequent catheter dosing was performed as an outpatient, twice a day using 0.2% ropivacaine, 10 ml in each catheter (four injections total). This provided 96 hr of analgesia and low supplemental opioid use. CONCLUSION: The use of a lumbar plexus and sciatic nerve peripheral catheter offered an alternative to conventional pain control that worked well in the ambulatory setting. By providing prolonged unilateral lower limb analgesia, extensive knee surgery was performed that would normally require a hospital stay for pain control. Using a bolus dosing method the risk of local anesthetic complications occurring outside of the hospital with a continuous infusion was minimized.

Full Text

Duke Authors

Cited Authors

  • Klein, SM; Greengrass, RA; Grant, SA; Higgins, LD; Nielsen, KC; Steele, SM

Published Date

  • April 2001

Published In

Volume / Issue

  • 48 / 4

Start / End Page

  • 375 - 378

PubMed ID

  • 11339780

Pubmed Central ID

  • 11339780

International Standard Serial Number (ISSN)

  • 0832-610X

Language

  • eng

Conference Location

  • United States