Table 5.
Nerve Block Techniques for Hip and Knee Surgeries
| Nerve Block Technique | Indications | Advantages | Limitations |
|---|---|---|---|
| Lumbar and Sacral Plexus Block | Lower limb surgeries such as hip and femoral surgeries | Stable blood pressure, postoperative comfort, reduced hospital stays, lower costs | Adverse effects of local anesthetic, including muscle weakness |
| Psoas Compartment Block (PCB) | Hip, femoral, or knee surgery | Alleviates postoperative pain, effective for 48 hours (continuous) | Several complications, such as organ injury when not well-monitored |
| Femoral Nerve Block | Hip or knee surgery, ACL reconstruction (combined with sciatic nerve block) | Better pain relief than local infiltration | May not provide effective analgesia for hip surgery, fall risks, allergy to local anesthetic |
| PENG Block | Hip replacement surgery | Reduced pain during movement, lower opioid use, faster recovery | Conflicting research on postoperative analgesia effectiveness, pain at injection site, infection |
| Local Anesthesia Infiltration (LAI) | Various surgeries (including hip and knee) | Comparable pain relief to single nerve block | Pain at injection site, infection, bleeding |
| Adductor Canal Block (ACB) | TKA | Improved early pain control, reduced opioid use, improved sleep quality (combined with LIA) | Adverse effects of local anesthetic, discomfort at injection site |
| Fascia Iliaca Compartment Block (FICB) | Hip, femur, and knee surgeries | Reduced pain scores, reduced need for rescue analgesia and postoperative complications | Adverse effects of local anesthetic, reduced muscle strength, infection, and allergy |
| Saphenous Nerve Block | Knee surgery (especially for high-risk patients) | Improved pain relief | Local anesthetic toxicity, pain at injection site, infection, bleeding, quadriceps weakness |
| Sciatic Nerve Block | Leg surgeries | Effective pain management | Adverse effects of local anesthetic, including toxicity, discomfort at injection site, infection, and bleeding |
| Popliteal Nerve Block (PSNB) | Leg surgeries | Effective pain management, improved patient comfort | Adverse effects of local anesthetic, including toxicity, discomfort at injection site, infection, and bleeding |
Notes: These nerve block techniques are widely used in various lower limb surgeries to provide effective regional pain relief, although each approach has its unique risks and limitations that require careful consideration during implementation.