• Anesthesia and analgesia · Dec 2010

    The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.

    • Brian M Ilfeld, Kimberly B Duke, and Michael C Donohue.
    • Department of Anesthesiology, University of California San Diego, San Diego, California, USA. bilfeld@ucsd.edu
    • Anesth. Analg. 2010 Dec 1; 111 (6): 155215541552-4.

    BackgroundContinuous peripheral nerve blocks (CPNB) may induce muscle weakness, and multiple recently published series emphasize patient falls after postarthroplasty CPNB. However, none have included an adequate control group, and therefore the relationship between CPNB and falls remains speculative.MethodsWe pooled data from 3 previously published, randomized, triple-masked, placebo-controlled studies of CPNB involving the femoral nerve after knee and hip arthroplasty.ResultsNo patients receiving perineural saline (n = 86) fell (0%; 95% confidence interval [CI] = 0%-5%), but there were 7 falls in 6 patients receiving perineural ropivacaine (n = 85; 7%; 95% CI = 3%-15%; Fisher's exact test P = 0.013).ConclusionsOur analysis suggests that there is a causal relationship between CPNB and the risk of falling after knee and hip arthroplasty.

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