Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk
Yacout, A., ELHoshy, H. (2023). Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk. EKB Journal Management System, 39(1), 177-184. doi: TEJA-2022-0209
A G Yacout; H S ELHoshy. "Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk". EKB Journal Management System, 39, 1, 2023, 177-184. doi: TEJA-2022-0209
Yacout, A., ELHoshy, H. (2023). 'Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk', EKB Journal Management System, 39(1), pp. 177-184. doi: TEJA-2022-0209
Yacout, A., ELHoshy, H. Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk. EKB Journal Management System, 2023; 39(1): 177-184. doi: TEJA-2022-0209

Continuous femoral nerve block enhances outcome of spinal anaesthesia in preventing perioperative cardiac complications in patients with cardiac risk

Egyptian Journal of Anaesthesia
Volume 39, Issue 1, December 2023, Page 177-184  XML PDF (578.87 K)
DOI: TEJA-2022-0209
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Authors
A G Yacout; H S ELHoshy
Abstract
Background
Elevated brain natriuretic peptide (BNP) is crucial to detect perioperative adverse cardiovascular events in patients with cardiac risk, even at low elevation of BNP level or when myocardial necrosis has not been already established. This study aims to compare between two anaesthesia methods in preventing perioperative myocardial infarction for patients having cardiac risk undergoing total knee arthroplasty (TKA).
Patients and methods
Fifty adult patients planned for TKA with risk factors as ischemic heart disease, diabetics, hypertensive, heavy smokers or body mass index ≥ 35 were categorized randomly into two groups. Group (S): received spinal anaesthesia followed by continuous ultrasound guided femoral nerve block once spinal motor blockade had been resolved. Group (G): received combined general and lumber epidural anaesthesia. BNP, cardiac troponins, pain severity, analgesic consumption, patients’ satisfaction and adverse cardiac events were observed preoperatively and extended to 2 days postoperatively.
Results
Baseline readings of BNP and cardiac troponins were comparable in both members. At 24 and 48 hours postoperatively, it decreased significantly in group S compared to group G. Mean Visual analogue score was significantly lower in group S comparative to group G at all times except at 40 and 48 hours postoperatively. Morphine utilization was significantly lower in group S. Patients in group S were significantly more satisfied than those in group G.
Conclusions
The use of spinal anaesthesia with continuous femoral nerve block can reduce the prevalence of perioperative myocardial infarction in patients with cardiac risk undergoing TKA.
Keywords
BNP; Cardiac troponin; myocardial infarction; TKA
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