Novel utilization of fascial layer blocks in hip and knee procedures

Best Pract Res Clin Anaesthesiol. 2019 Dec;33(4):539-551. doi: 10.1016/j.bpa.2019.07.010. Epub 2019 Jul 17.

Abstract

Purpose: of review: Novel motor-sparing peripheral nerve blocks in hip and knee procedures are desirable.

Recent findings: The application of ultrasound (US) in fascial plane blocks has improved the efficacy and effectiveness of obturator nerve block, lateral femoral cutaneous nerve block, and quadratus lumborum block. The improved performance of these fascial plane blocks has led to additional clinical applications to the hip and knee procedures.

Summary: Recent advancements in US have transformed the clinical performance of fascial layer blocks, evidenced in their novel indications in hip, knee, and spine analgesia. The combination of various motor-sparing fascial plane blocks providing different areas of innervation is particularly useful in fast-track hip and knee surgeries.

Keywords: hip; knee; lateral femoral cutaneous nerve block; motor-sparing; obturator nerve block; quadratus lumborum block.

Publication types

  • Review

MeSH terms

  • Anesthetics, Local / administration & dosage
  • Autonomic Nerve Block / methods*
  • Fascia* / diagnostic imaging
  • Femoral Nerve / diagnostic imaging
  • Femoral Nerve / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery*
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Pain, Postoperative / diagnostic imaging
  • Pain, Postoperative / prevention & control

Substances

  • Anesthetics, Local