Incidence and severity of complications due to femoral nerve blocks performed for knee surgery

• Published in: The knee Vol. 20; no. 3; pp. 181 - 185
• Main Authors: Widmer, Benjamin, Lustig, Sébastien, Scholes, Corey J, Molloy, Allen, Leo, Sean P.M, Coolican, Myles R.J, Parker, David A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2013; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia; Anesthesia, Local - adverse effects; Arthroplasty - adverse effects; Australia - epidemiology; Complications; Female; Femoral Nerve - drug effects; Femoral nerve block; Health care; Humans; Incidence; Joint surgery; Knee; Knee Joint - surgery; Male; Middle Aged; Nerve Block - adverse effects; Orthopedics; Pain management; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - pathology; Postoperative period; Surveys and Questionnaires; Young Adult; Australia; Knee; Complications; Femoral nerve block
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2012.11.002

Abstract Background: While single shot femoral nerve blocks and indwelling femoral nerve catheters provide significant peri-operative analgesia, there are small but serious risks of neurovascular complications. We aimed to determine the incidence and characterise the nature of neural complications arising from femoral nerve blocks performed for knee surgery. Methods: One thousand eight hundred and two patients receiving a femoral nerve block for knee surgery during the study period were screened. Patients with possible neurological symptoms were evaluated with a detailed physical examination and self-report questionnaires. Also measures of depression, anxiety and tension/stress were collected. Results: In the patients screened, an incidence of 1.94% was found. Of the 24 patients available for testing, 4 had bilateral symptoms following bilateral nerve blocks. All had sensory abnormalities in the distribution of the femoral nerve. The incidence was significantly higher in females (females = 2.5%, males = 0.83% p = 0.01) and in patients receiving a single shot block (single shot = 2.66%, femoral catheter = 0.93, p = 0.01). Conclusions: The incidence of neurological complication after FNB was higher in this series than typically reported and the symptoms significantly influenced the quality of life in the affected cases. The decision to include a femoral nerve block in the peri-operative analgesic regimen should be made on an individual basis considering the risks and benefits. Level of evidence Therapeutic level IV.