2 responses to “April Hits (2015)”

  1. Hunter Stark

    Aaron,

    Saphenous nerve blocks are superior to femoral nerve blocks in many ways: 1. they block a majority of the same area as the femoral nerve block while not blocking motor function. 2. If the patient can actually activate their muscles post-operatively and regain function faster then they gain additional trust in their affected extremity after surgery. 3. Able to perform PT (i.e., strengthening, ROM, and WB activities) at a faster rate after surgery. 4. Less post-operative complications noted as compared to femoral nerve block.

    Our anesthesiologist has been great at changing full-time to use of the saphenous nerve block due to our feedback in the rehab clinic and improved function of patients after ACL reconstruction (main use in our clinic but they are gradually switching to utilization after TKA).

  2. Aaron Swanson

    My good friend and fellow PT, Josh Gellert, sent me this quick research review on Femoral Nerve Blocks.

    “In this comparative study, a continuous femoral nerve block had an adverse effect on quadriceps strength at 6 months following patellar tendon autograft ACL reconstruction compared to a control group.
    https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0034-1371769

    Significant isokinetic deficits in knee extension and flexion strength at 6 months when compared with patients who did not receive a nerve block.Patients without a block were 4 times more likely to meet criteria for clearance to return to sports at 6 months.
    http://ajs.sagepub.com/content/43/2/331.full.pdf+html

    FNB may reduce pain on the night of surgery. However, this may not be clinically significant. FNB is not recommended at this time for use in outpatient ACL reconstruction with hamstring graft.
    https://www.ncbi.nlm.nih.gov/pubmed/10750003

    FNBs have not been shown to significantly affect patient pain, readiness for discharge, or outcome scores. There is a small but identifiable risk associated with performing FNBs, with potentially catastrophic effect
    http://ac.els-cdn.com/S0749806309007361/1-s2.0-S0749806309007361-main.pdf?_tid=7305099c-ed04-11e4-ac75-00000aacb361&acdnat=1430156589_cc9c792e2b3f7195db258e3391372efd

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