The analgesic impact of preoperative lumbar plexus blocks for hip arthroscopy. A retrospective review.

This study aimed to examine the impact of preoperative lumbar plexus blockade on perioperative analgesia and opioid consumption following hip arthroscopy. The records of patients (n = 236) who underwent hip arthroscopy between July 27, 2004 and November 15, 2009 were reviewed (118 patients with preoperative lumbar plexus block and 118 procedure matched patients without a preoperative block). Baseline patient characteristics were similar between groups. Immediate post-anaesthesia care unit (PACU) pain scores, peak PACU pain scores, perioperative opioid administration, and PACU antiemetic administration favoured preoperative block placement. Postoperative modified Harris Hip scores and postoperative day one pain scores were similar between groups. Total hospital time following the surgical procedure was longer in the block group. While preoperative lumbar plexus blockade may be helpful for analgesia following hip arthroscopy, more research needs to be done to determine the ideal analgesic regimen for these patients.

Epidural anesthesia as a novel anesthetic technique for anterior lumbar interbody fusion.

STUDY OBJECTIVE: To determine if epidural anesthesia is a reasonable technique for anterior lumbar interbody fusion. DESIGN: Retrospective chart review. SETTING: Academic university hospital. MEASUREMENTS: The charts of patients who underwent an anterior lumbar interbody fusion between January 1, 2001 and November 1, 2008 were reviewed. A total of 102 consecutive patients, of whom 19 received an epidural and 83 underwent general anesthesia, met inclusion criteria. Postoperative pain, nausea, opioid administration, operating room time, anesthesia time, Postanesthesia Care Unit (PACU) time, and total hospital time were compared. MAIN RESULTS: In the PACU, patients receiving epidural anesthesia showed reductions in median immediate [numerical rating scale (NRS) 0 vs 7; P < 0.001] and peak (NRS 4 vs 8; P = 0.001) postoperative pain scores, and postoperative mean arterial pressure (69.7 vs 90.3; P < 0.001). Epidural anesthesia patients also needed significantly less intravenous morphine-equivalent medication both intraoperatively (5 vs 29; P < 0.001) and postoperatively (3.34 vs 10; P = 0.021). CONCLUSIONS: Epidural anesthesia for anterior lumbar interbody fusion is potentially beneficial compared with general anesthesia, showing improved perioperative pain control.