Patient satisfaction and effectiveness of lumbar plexus and sciatic nerve block for total knee arthroplasty

The purpose of this study was to evaluate the efficacy of combined lumbar p lexus block techniques for total knee arthroplasty. Long-acting local anest hetics were used to ensure adequate intraoperative and postoperative anesth esia and analgesia. All patients undergoing total knee arthroplasty at our institution were offered lumbar plexus block after obtaining informed conse nt. Patients for study were a continuous group of 87 patients over a 1-year period. A subset of 40 patients was studied for postoperative analgesia ef fect. All patients were contacted by phone for a satisfaction survey. There were 87 patients who received initial lumbar plexus and sciatic nerve bloc ks, 78% (68 of 87) of whom had adequate initial blocks. Sixteen patients (2 2%) required conversion to general anesthesia intraoperatively because of i nadequate anesthesia. A subset of patients studied for postoperative analge sia revealed an average time of 13 hours before the first request for suppl emental narcotics. There were no complications related to the lumbar plexus block in our study group of patients. There was a 92% overall satisfaction rate with the anesthesia provided by the lumbar plexus block. Lumbar plexu s block can be used successfully for total knee arthroplasty. Lumbar plexus block appears to have advantages for early postoperative analgesia, leadin g to increased patient comfort and satisfaction.