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Ultrasound-guided genitofemoral nerve block for femoral arterial access gain and closure: a randomized controlled trial

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A Letter to the Editor to this article was published on 06 November 2023

Abstract

Objectives

This study aimed to compare the analgesic efficacy and safety of the femoral branch block of the genitofemoral nerve (FBB) versus local infiltration anesthesia (LIA) for femoral arterial access gain and closure.

Methods

Eighty-two patients (age, 64.8 ± 10.9 years; female, 30.5%) undergoing endovascular procedures using 5-Fr femoral sheath were assigned to either FBB (n = 41) or LIA (n = 41). In both groups, 2% lidocaine HCL with 1:100,000 epinephrine was used as an anesthetic solution. Pain scores during access gain and closure were evaluated using a visual analog scale (score 0–10), patient satisfaction levels with the quality of anesthesia were scored on a 7-point Likert scale, and adverse events were recorded.

Results

The primary endpoint, pain scores during access closure, was significantly lower in the FBB group than in the LIA group (0.1 ± 0.37 vs 1.73 ± 0.92; p < 0.001). The FBB group also had significantly lower pain scores during access gain compared to the LIA group (0.83 ± 0.83 vs 2.78 ± 1.26; p < 0.001). There was an inverse relationship between pain scores and FBB after adjustment for age, gender, and body mass index (p < 0.001). FBB group reported significantly higher satisfaction with anesthesia quality compared to the LIA group (6.49 ± 0.64 vs 4.05 ± 1.05; p < 0.001). No complications were recognized in either group.

Conclusions

Ultrasound-guided genitofemoral nerve blocks offered better acute pain relief and higher patient satisfaction than LIA during femoral arterial access gain and closure.

Clinical relevance statement

In this prospective randomized controlled trial, ultrasound-guided genitofemoral nerve blocks offered better acute pain relief than local infiltration anesthesia, resulting in enhanced patient satisfaction.

Key Points

• FBB provided better pain relief during access gain and closure than LIA.

• FBB offered higher patient satisfaction with the quality of anesthesia than LIA.

• No anesthesia-related or access site complications were recognized in either treatment group.

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Abbreviations

FBB:

Femoral branch block of the genitofemoral nerve

LIA:

Local infiltration anesthesia

RCT:

Randomized controlled trial

VAS:

Visual analog scale

VCD:

Vascular closure device

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Funding

This work was supported by the Soonchunhyang University Research Fund. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea

    Youngjong Cho

  2. Department of Radiology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea

    Sung-Joon Park

  3. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea

    Hyoung Nam Lee, Woong Hee Lee & Seung Soo Kim

  4. Vascular Center, The Eutteum Orthopedic Surgery Hospital, Paju, Korea

    Sangjoon Lee

  5. Clinical Trial Center, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea

    Nam Hun Heo

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  1. Youngjong Cho
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Corresponding author

Correspondence to Hyoung Nam Lee.

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Guarantor

The scientific guarantor of this publication is Hyoung Nam Lee (Soonchunhyang University College of Medicine, Cheonan Hospital).

Conflict of Interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and Biometry

“Clinical Trial Center at Soonchunhyang University College of Medicine, Cheonan Hospital” kindly provided statistical advice for this manuscript.

Informed Consent

Written informed consents were obtained from all patients.

Ethical Approval

Institutional review board approval was obtained.

Study subjects or cohorts overlap

None of the study subjects or cohorts have been previously reported.

Methodology

• Prospective

• Randomized controlled trial

• Performed at one institution

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Youngjong Cho and Sung-Joon Park contributed equally to this work and are co-first authors of this work.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Movie1 This video demonstrates ultrasound-guided genitofemoral nerve block. (MP4 57910 KB)

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Cho, Y., Park, SJ., Lee, H.N. et al. Ultrasound-guided genitofemoral nerve block for femoral arterial access gain and closure: a randomized controlled trial. Eur Radiol 34, 1123–1131 (2024). https://doi.org/10.1007/s00330-023-10148-7

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  • DOI: https://doi.org/10.1007/s00330-023-10148-7

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