Universität zu Köln

Bomberg, Hagen, Huth, Andrea, Wagenpfeil, Stefan, Kessler, Paul, Wulf, Hinnerk, Standl, Thomas, Gottschalk, Andre, Doeffert, Jens, Hering, Werner, Birnbaum, Juergen, Spies, Claudia ORCID: 0000-0002-1062-0495, Kutter, Bernd, Winckelmann, Joerg, Burgard, Gerald, Vicent, Oliver, Koch, Thea, Sessler, Daniel I., Volk, Thomas and Raddatz, Alexander (2017). Psoas Versus Femoral Blocks A Registry Analysis of Risks and Benefits. Region. Anesth. Pain Med., 42 (6). S. 719 - 725. LONDON: BMJ PUBLISHING GROUP. ISSN 1532-8651

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Abstract

Background and Objectives: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection. We thus tested the hypothesis that psoas blocks are associated with more insertion-related complications than femoral blocks but have fewer catheter-related infections. Methods: We extracted 22,434 surgical cases from the German Network for Regional Anesthesia registry (2007-2014) and grouped cases as psoas (n = 7593) and femoral (n = 14,841) blocks. Insertion-related complications (including single-shot blocks and catheter) and infectious complications (including only catheter) in each group were compared with chi(2) tests. The groupswere compared with multivariable logistic models, adjusted for potential confounding factors. Results: After adjustment for potential confounding factors, psoas blocks were associated with more complications than femoral blocks including vascular puncture 6.3% versus 1.1%, with an adjusted odds ratio (aOR) of 3.6 (95% confidence interval [CI], 2.9-4.6; P < 0.001), and multiple skin punctures 12.6% versus 7.7%, with an aOR of 2.6 (95% CI, 2.1-3.3; P < 0.001). Psoas blockswere also associatedwith fewer catheter-related infections: 0.3% versus 0.9% (aOR of 0.4; 95% CI, 0.2-0.8; P = 0.016), and with improved patient satisfaction (mean +/- SD 0- to 10-point scale score, 9.6 +/- 1.2 vs 8.4 +/- 2.9; P < 0.001). Results from a propensity-matched sensitivity analysis were similar. Conclusions: Psoas blocks are associated with more insertion-related complications but fewer infectious complications.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bomberg, Hagen UNSPECIFIED UNSPECIFIED UNSPECIFIED Huth, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagenpfeil, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kessler, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulf, Hinnerk UNSPECIFIED UNSPECIFIED UNSPECIFIED Standl, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Gottschalk, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Doeffert, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Hering, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Birnbaum, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Spies, Claudia UNSPECIFIED orcid.org/0000-0002-1062-0495 UNSPECIFIED Kutter, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Winckelmann, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgard, Gerald UNSPECIFIED UNSPECIFIED UNSPECIFIED Vicent, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Thea UNSPECIFIED UNSPECIFIED UNSPECIFIED Sessler, Daniel I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Volk, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Raddatz, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-211684
DOI:	10.1097/AAP.0000000000000643
Journal or Publication Title:	Region. Anesth. Pain Med.
Volume:	42
Number:	6
Page Range:	S. 719 - 725
Date:	2017
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1532-8651
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ANESTHETIC SYSTEMIC TOXICITY; REGIONAL-ANESTHESIA; LUMBAR PLEXUS; POSTOPERATIVE ANALGESIA; NERVE BLOCK; COMPLICATIONS; CATHETER Multiple languages Anesthesiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21168