Femoral-Obturator-Sciatic (FOS) Nerve Block as an Anesthetic Triad for Arthroscopic ACL Reconstruction: Is This the Magic Trick We Were Missing?
Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. Peripheral nerve blockade as an anesthetic technique is an appealing option in the era of modern anesthesia. The aim of this narrativ...
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| creator | Bareka, Metaxia Ntalouka, Maria P Angelis, Fragkiskos Mermiri, Maria Tsiaka, Aikaterini Hantes, Michael Arnaoutoglou, Eleni |
| description | Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. Peripheral nerve blockade as an anesthetic technique is an appealing option in the era of modern anesthesia. The aim of this narrative review is to document the efficacy and safety of the combination of femoral, obturator, and sciatic (FOS) nerve blocks as an exclusive method for anesthesia in patients undergoing ACL reconstruction. An electronic search of the literature published up to October 2023 was conducted in the Medline, Embase, Cochrane, Web of Science, and Google Scholar databases to find studies on ACL reconstruction and peripheral obturator nerve block. Overall, 8 prospective studies-with a total of 315 patients-published between 2007 and 2022 were included in this review. Ultrasound-guided peripheral FOS nerve blockade is an effective anesthetic technique for ACL reconstruction, offering good perioperative pain management, minimal opioid consumption, and an excellent safety profile. Further well-designed prospective studies are needed to determine the best approach for obturator nerve blockade and the appropriate type and dosage of local anesthetic. |
| doi_str_mv | 10.3390/jcm13041054 |
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Peripheral nerve blockade as an anesthetic technique is an appealing option in the era of modern anesthesia. The aim of this narrative review is to document the efficacy and safety of the combination of femoral, obturator, and sciatic (FOS) nerve blocks as an exclusive method for anesthesia in patients undergoing ACL reconstruction. An electronic search of the literature published up to October 2023 was conducted in the Medline, Embase, Cochrane, Web of Science, and Google Scholar databases to find studies on ACL reconstruction and peripheral obturator nerve block. Overall, 8 prospective studies-with a total of 315 patients-published between 2007 and 2022 were included in this review. Ultrasound-guided peripheral FOS nerve blockade is an effective anesthetic technique for ACL reconstruction, offering good perioperative pain management, minimal opioid consumption, and an excellent safety profile. Further well-designed prospective studies are needed to determine the best approach for obturator nerve blockade and the appropriate type and dosage of local anesthetic.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13041054</identifier><identifier>PMID: 38398367</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Analgesics ; Care and treatment ; Epidural ; General anesthesia ; Injuries ; Knee ; Morphine ; Nerve block ; Pain ; Pain management ; Patient outcomes ; Patients ; Qualitative research ; Search strategies ; Ultrasonic imaging</subject><ispartof>Journal of clinical medicine, 2024-02, Vol.13 (4), p.1054</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c379t-ab1b501f5f55fc29bdb0a6bb1b81c8cb841d4b95249dcd464f5c05f08953fd743</cites><orcidid>0000-0003-2458-9342 ; 0000-0001-9008-0005 ; 0000-0001-9057-7142 ; 0000-0002-1392-0135 ; 0000-0001-9494-6048</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38398367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bareka, Metaxia</creatorcontrib><creatorcontrib>Ntalouka, Maria P</creatorcontrib><creatorcontrib>Angelis, Fragkiskos</creatorcontrib><creatorcontrib>Mermiri, Maria</creatorcontrib><creatorcontrib>Tsiaka, Aikaterini</creatorcontrib><creatorcontrib>Hantes, Michael</creatorcontrib><creatorcontrib>Arnaoutoglou, Eleni</creatorcontrib><title>Femoral-Obturator-Sciatic (FOS) Nerve Block as an Anesthetic Triad for Arthroscopic ACL Reconstruction: Is This the Magic Trick We Were Missing?</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring grafting is a common orthopedic procedure that is associated with moderate-to-severe pain. 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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Analgesics Care and treatment Epidural General anesthesia Injuries Knee Morphine Nerve block Pain Pain management Patient outcomes Patients Qualitative research Search strategies Ultrasonic imaging |
| title | Femoral-Obturator-Sciatic (FOS) Nerve Block as an Anesthetic Triad for Arthroscopic ACL Reconstruction: Is This the Magic Trick We Were Missing? |
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