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An iliopsoas plane block does not cause motor blockade: A blinded randomized volunteer trial

Acta Anaesthesiologica Scandinavica Nov 01, 2019

Nielsen ND, Madsen MN, Østergaard HK, et al. - Given the use of a femoral nerve block for providing analgesia following total hip arthroplasty is controversial because of motor paralysis accompanied by an increased risk of fall, and only a cadaver study has suggested that the iliopsoas plane block targets the hip articular branches of the femoral nerve without motor blockade, therefore, researchers undertook this volunteer study to look at reduction of maximal force of knee extension following iliopsoas plane block vs baseline as well as reduction of maximal force of hip adduction, and the pattern of injectate spread evaluated with magnetic resonance imaging after randomization of 20 healthy volunteers to blinded paired active vs sham iliopsoas plane block (5 mL lidocaine 18 mg/mL with epinephrine vs saline). Following an iliopsoas plane block, no significant decrease in the maximal force of knee extension was reported. The injectate was contained in a fascial compartment earlier demonstrated to accommodate all sensory branches from the femoral nerve to the hip joint. Reduced risk of fall could be observed as the clinical result of selective anaesthesia of all sensory femoral nerve branches from the hip vs a traditional femoral nerve block.
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