PERIPHERAL NERVE BLOCKS FOR KNEE-SURGERY
Keywords:
knee-surgery, peripheral nerve blocks, femoral nerve blockAbstract
The aim of this article is to conduct an analysis of modern methods of peripheral nerve blocks (PNB) in knee-surgery. In this article an evolution from epidural anesthesia to motor-sparing blocks during last decades will be shown. Knee-surgeries can be performed under general anesthesia, neuraxial anesthesia, PNB or their combination. The drawbacks of epidural anesthesia caused decreasing of its dominant position in regional anaesthesia. Different PNBs of lower limb are used for knee-surgeries. They have become a key element of multimodal analgesia. Femoral nerve block is considered to be a gold standard of postoperative analgesia after total knee-arthroplasty. Recently, the growing interest to preserve quadriceps muscle strength after major-knee surgery was observed. Avoidance of quadriceps weakness enhances rehabilitation. Adductor canal block may be good option for these objectives. Other motor sparing blocks will be examined further. Conclusion. Modern regional anaesthesia has got different methods, which can be used depending on the needs of patient, surgeon, anaesthetist and health service.
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