An observational study of combined continuous lumbar plexus and single-shot sciatic nerve blocks for post-knee surgery analgesia.

Background and Objectives In a study of postoperative analgesia after major knee surgery, an assessment was made of the efficacy of continuous lumbar plexus block combined with a single-shot block of the sciatic nerve. Methods Continuous perivascular femoral and parasacral sciatic nerve blocks were performed in 59 patients of both sexes, who had undergone either total knee replacement or cruciate ligament reconstruction. An independent assessment of postoperative pain control and side effects was made. Results The combination technique produced pain control of good quality, combined with a low incidence of excessive sedation and emesis. Nausea and vomiting were infrequent, and no excess sedation, untoward side effects, or complications were noted. Conclusions Sciatic nerve block is essential for successful analgesia during the immediate postoperative period but is not mandatory for longer-term pain control, which can be achieved by continuous lumbar plexus block.