BACKGROUND Clinically significant spontaneous bilateral iliopsoas hematoma is a rare complication of anticoagulation therapy. Definitive treatment of spontaneous iliopsoas hematomas is not well-established and varies between observation and surgical intervention. The intramuscular hematoma causes severe pain, muscle dysfunction, and occasionally nerve palsy with the femoral nerve most commonly ...

Patients frequently experience postoperative pain after a total knee arthroplasty; such pain is always challenging to treat and may delay the patient's recovery. It is unclear whether local infiltration or a femoral nerve block offers a better analgesic effect after total knee arthroplasty.We performed a systematic review and meta-analysis of randomized controlled trials to compare local infilt...

The anaesthetic management of children with glycogen-storage disease type IIa (Pompe's disease) presents a variety of challenges. A modification of a femoral nerve block, the inguinal paravascular block, as described by Winnie, was used in conjunction with intravenous ketamine to provide anaesthesia for a diagnostic muscle biopsy in a 5.5-month-old infant with Pompe's disease. A peripheral nerv...

OBJECTIVES Acetabular retractors have been implicated in damage to the femoral and obturator nerves during total hip replacement. The aim of this study was to determine the anatomical relationship between retractor placement and these nerves. METHODS A posterior approach to the hip was carried out in six fresh cadaveric half pelves. Large Hohmann acetabular retractors were placed anteriorly, ...

To investigate adrenergic control of blood vessels during aging, rats aged 6, 12, 20, and 27 months were studied using in vitro techniques. Accumulation of [3H]norepinephrine, one index of adrenergic nerve density, did not alter with age in the femoral or renal arteries or renal vein. In the femoral vein [3H]norepinephrine accumulation was greater at 6 and 27 months of age. Norepinephrine sensi...

STUDY OBJECTIVE To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy. DESIGN Prospective, randomized, controlled study. SETTING Postoperative recovery area at a university-affiliated medical center. PATIENTS 50 ASA physical status I and II adult outpatients undergoing arthroscopic knee surgery. INTERVENTIONS Study subjects were equally di...

We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colou...

We read with great interest the article of Wang et al.1 concerning the use of continuous local anesthetic infusion via catheters placed with ultrasound guided and nerve stimulator beside femoral nerve for postoperative analgesia after total knee arthroplasty (TKA). We congratulate them on the presentation of the article. However, we would like to add some comments. We agree with author that reh...

BACKGROUND The PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypoth...

This article follows an In-depth piece published in last week's issue, which explored issues around pain management in older people following fractured neck of femur. It also discussed using femoral nerve block for pain relief in this group of patients. This Changing Practice article outlines the establishment of a nurse-led service to improve pre-operative pain management using femoral nerve b...