The comparison of two lower extremity block techniques combined with sciatic block: 3-in-1 femoral block vs. psoas compartment block.

The objective of this study was to compare clinical and postoperative analgesic effects of femoral or psoas compartment blocks in patients undergoing arthroscopies. Fifty patients were randomly assigned to one of the two groups. Either femoral (group F) or psoas compartment (group P) block was applied followed by sciatic nerve block. All nerve blocks were provided with a 15 ml of bupivacaine 0.5% + 10 ml of lignocaine (lidocaine) 2%. Systolic and diastolic blood pressure (SBP and DBP), heart rate, and pulse oxymetry (SpO2) were recorded. Quality of anaesthesia, time to first analgesic use, verbal pain scores (VPS), sensorial and motor blockade resolution times and side effects were also recorded. Quality of anaesthesia, complete sensory blockade of obturator and lateral cutaneous nerves were higher in the group P than in group F. However, complete motor blockade findings were similar in both groups. In the group P, VPS values measured at 10 and 15 min were lower than that of group F. These values decreased at 10 min and thereafter as to baseline values. VPS values of the group F declined at 20 min and following measurement times as to baseline values. Durations of motor and sensorial block, and time to first analgesic use were similar between two groups. Total analgesic consumption at first 24 h in group P was lower than those of group F. Regarding heart rates, SpO2, SBP and DBP values, no significant differences were found between the groups. Combined psoas-sciatic technique provided more comfortable intraoperative anaesthesia and better postoperative analgesia when compared with femoral-sciatic technique for arthroscopic procedures.

Evaluation of computed tomographic methods to measure vertebral rotation in adolescent idiopathic scoliosis: an intraobserver and interobserver analysis.

The purpose of this study was to compare three computed tomography (CT) measurement methods that have been described by Aaro-Dahlborn, Ho, and Krismer et al. The methods were based on clinical, intraobserver, and interobserver analysis. Twenty-five patients with adolescent idiopathic scoliosis were studied for clinical reliability of these methods. There was a significant correlation between Aaro-Dahlborn and Ho's methods (p < 0.02), and there was no correlation between Krismer's method and the other two (p > 0.05). Intraobserver analysis was performed by one observer at 20 different times, and interobserver analysis was performed by 20 orthopedic surgeons on the same CT scan. Intraobserver and interobserver analysis has shown that the method described by Ho is the most reliable one. Consequently, Ho's method is the most reliable and clinically the most useful method for measuring the vertebral rotation in adolescent idiopathic scoliosis.

Intra-articular hemangioma of the knee with meniscal and bony attachment.

A hemangioma in the knee joint of a 37-year-old woman was diagnosed by magnetic resonance imaging. The case presented with pain and a tender localized swelling lateral to the patellar tendon. Arthroscopy verified the diagnosis but did not allow visualization of the full extent of the tumor. After arthroscopic subtotal excision of the associated hypertrophic medial plica, a miniarthrotomy was done. The tumor was attached to the periphery of the anterior horn of the lateral meniscus, to the anterior tibial plateau, and to the fat pad. It seemed to take its origin from the venous plexus just below the anterior lip of the central tibial plateau. The patient was asymptomatic 9 months after surgery. In hemangiomas not amenable to arthroscopic surgery, open excision through miniarthrotomy ensures complete removal without prolonging recovery.