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Acute Pain Management Protocol for Pelvic, Hip and Proximal Femur Procedures

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First Aid Perioperative Ultrasound
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Abstract

Regional anesthesia is an important adjunct for analgesia following hip, pelvis, and upper leg procedures. These techniques are utilized in a variety of patient populations including trauma, sports medicine, and geriatrics. Benefits of regional anesthesia in these populations include reduced opioid requirements, which minimizes side-effects of these medications. Nerve blocks may be performed before or after the planned procedure and special consideration of the risks, benefits, complications, and alternatives of regional anesthesia should be considered given the type or surgery and specific patient characteristics. Common blocks used to provide analgesia to the hip, pelvis, and upper leg include lumbar plexus, fascia iliaca, femoral, and obturator nerve blocks. This chapter discusses common surgical procedures of the hip, pelvis, and upper leg and applicable regional anesthetic techniques.

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References

  1. Tran DQ, Salinas FV, Benzon HT, Neal JM. Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. 2019;44(2):143–80.

    Article  Google Scholar 

  2. Hadzic A, editor. Hadzic’s textbook of regional anesthesia and acute pain management. 2nd ed. New York, NY: McGraw-Hill Education; 2017.

    Google Scholar 

  3. Vloka JD, Hadzic A, Drobnik L, Ernest A, Reiss W, Thys DM. Anatomical landmarks for femoral nerve block: a comparison of four needle insertion sites. Anesth Analg. 1999;89(6):1467.

    CAS  PubMed  Google Scholar 

  4. Hara K, Sakura S, Shido A. Ultrasound-guided lateral femoral cutaneous nerve block: comparison of two techniques. Anaesth Intensive Care. 2011;39(1):69–72.

    Article  CAS  PubMed  Google Scholar 

  5. Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail’s clinical anesthesiology. New York, NY: McGraw-Hill; 2013.

    Google Scholar 

  6. Pardo M, Miller RD. Basics of anesthesia e-book. Philadelphia, PA: Elsevier Health Sciences; 2017.

    Google Scholar 

  7. Desmet M, Balocco AL, Van Belleghem V. Fascia iliaca compartment blocks: different techniques and review of the literature. Best Pract Res Clin Anaesthesiol. 2019;33(1):57–66.

    Article  PubMed  Google Scholar 

  8. Amato PE, Thames MR. How I do it: suprainguinal fascia iliaca block. ASRA News. 2020:45.

    Google Scholar 

  9. Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT, Brown DL, Heit JA, Mulroy MF, Rosenquist RW, Tryba M. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines. Reg Anesth Pain Med. 2010;35(1):64–101.

    Article  CAS  PubMed  Google Scholar 

  10. Stevens RD, Van Gessel E, Flory N, Fournier R, Gamulin Z. Lumbar plexus block reduces pain and blood loss associated with total hip arthroplasty. J Am Soc Anesthesiol. 2000;93(1):115–21.

    Article  CAS  Google Scholar 

  11. Hanna MH, Peat SJ, d’Costa F. Lumbar plexus block: an anatomical study. Anaesthesia. 1993;48(8):675–8.

    Article  CAS  PubMed  Google Scholar 

  12. Awad IT, Duggan EM. Posterior lumbar plexus block: anatomy, approaches, and techniques. Reg Anesth Pain Med. 2005;30(2):143–9.

    PubMed  Google Scholar 

  13. Xiao JY, Fang Y, Yu Y, Li J, Luo YR, Liu Y, Mei W. Ultrasound guidance and nerve stimulation combined versus nerve stimulation alone for lumbar plexus block: a randomized controlled trial. Curr Med Sci. 2020;40(6):1182–90.

    Article  PubMed  Google Scholar 

  14. Liu Y, Ke X, Wu X, Mei W. Ultrasound-guided lumbar plexus block in supine position. Anesthesiology. 2018;128(4):812.

    Article  PubMed  Google Scholar 

  15. Jaffe RA, Schmiesing CA, Golianu B, editors. Anesthesiologist’s manual of surgical procedures. Philadelphia, PA: Lippincott Williams & Wilkins; 2014.

    Google Scholar 

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Correspondence to Nicole Hollis .

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Hollis, N., Glines, K. (2023). Acute Pain Management Protocol for Pelvic, Hip and Proximal Femur Procedures. In: Li, J., Jiang, W., Vadivelu, N. (eds) First Aid Perioperative Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-031-21291-8_22

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  • DOI: https://doi.org/10.1007/978-3-031-21291-8_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-21290-1

  • Online ISBN: 978-3-031-21291-8

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