• Neuber Martins Fonseca, Roberto Araújo Ruzi, Fernando Xavier Ferreira, and Fabrício Martins Arruda.
• CET, SBA, Faculdade de Medicina, Universidade Federal de Uberlândia.
• Rev Bras Anestesiol. 2003 Apr 1; 53 (2): 188-97.

Background And ObjectivesPerivascular Lumbar plexus inguinal block, (3-in-1 block) has been used for postoperative analgesia. This study aimed at comparing postoperative analgesia of 3-in-1 block and spinal morphine in patients submitted to lower limb orthopedic surgeries (LL).MethodsForty ASA I - II patients of both genders, aged 15 to 75 years, scheduled for LL orthopedic surgeries, were distributed in two groups: (M and LPB). Spinal anesthesia was performed in all patients at L3-L4 or L4-L5 with 20 mg of 0.5% isobaric bupivacaine. In group M (n = 20), 50 microg morphine were associated to local anesthetics. In group LPB (n = 20) 3-in-1 blockade was performed after surgery with 200 mg of 0.5% ropivacaine. Analgesia and pain intensity were evaluated at 4, 8, 12, 14, 16, 20 and 24 hours after surgery completion, in addition to spinal blockade level, surgery duration and complications.ResultsAnalgesia duration in group LPB was 13.1 +/- 2.47 while all group M patients referred pain and lack of motor block in the first moment evaluated (4 hours). There has been blockade failure in one of the three nerves in three patients. The incidence of nausea and pruritus was significantly higher in group M. There was no significant difference between groups in urinary retention. There were no respiratory depression, arterial hypotension or bradycardia. Postoperative analgesia was more effective in group LPB as compared to group M at 4, 8, 12, 14 and 16 hours. There were no significant differences between groups at 20 and 24 hours.ConclusionsPostoperative analgesia induced by 3-in-1 blockade showed less side-effects as compared to spinal morphine with similar analgesia duration.

6 keywords...

hide…