Lumbar Plexus Block for Post-Operative Analgesia following lower limb Orthopedic Surgery: A Comparison of ‘3 in 1’ and psoas compartment block

Abstract

Background: Pain is the most common symptom for which patient seeks medical care. Severe postoperative pain is common following orthopaedic surgery. There are a variety of methods used to address orthopedic postoperative pain like Opioids, epidural analgesia, patient-controlled analgesia, nerve blocks, Opioids-sparing NSAIDs, such as ketorolac and Lumbar Plexus Block. Here in this study two approaches of Lumbar plexus Block method used to provide postoperative analgesia following lower limb orthopedic surgery. Aims & Objectives: to compare efficacy for post operative analgesia by two different methods of lumbar plexus block namely Psoas compartment block and “3 in 1 blockâ€. Materials and Methods: The study was conducted in 60 adult patients. In pre-operative room pulse rate, blood pressure, respiratory rate and Verbal Rating Scale (VRS) for pain at rest and at movement were noted. Patients were divided into 2 groups in group ‘A’ patients received ‘3 in 1’ block following spinal anaesthesia at the end of surgery, in group ‘B’ Patient received Psoas Compartment Block following spinal anaesthesia at the end of surgery. In the postoperative period, patients were assessed at 1, 2, 4, 6, 12 and 24 hours after operation regarding the pain at operative site using four points verbal rating scale (none, mild, moderate or severe) both during rest and mobilization.The time of first analgesic, total doses of analgesics and any side effects were also recorded. Results: In group A (SA+'3 in 1' block) mean duration of analgesia was 11.83 hours whereas in group B duration of analgesia was 12.56 hours. There was no difference between two groups in respect of supplemental analgesia. Conclusion: Both approaches of single shot lumbar plexus block were effective in providing post operative analgesia after lower limb orthopedic surgery