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Bilateral Fascia Iliaca Catheters for Postoperative Pain Control After Bilateral Total Knee Arthroplasty: A Case Report and Description of a Catheter Technique
  1. Stephen R. Longo, M.D. and
  2. Daniel P. Williams, D.O.
  1. Department of Anesthesia, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania
  1. This case was performed at Hershey Medical Center. No grants were used for the purpose of completing this case. The case was not presented at any meeting.


Background and Objectives The pain following total knee arthroplasty can be associated with significant morbidity, especially in the elderly. Regional anesthetic techniques attenuate or eliminate postoperative pain, which may reduce this morbidity.

Methods A 74-year-old patient with history of an epidural abscess underwent elective bilateral total knee arthroplasty for degenerative joint disease. Bilateral lumbar plexus catheters were placed via the fascia iliaca compartments. Lidocaine was infused postoperative through both catheters, and serum lidocaine levels were followed.

Results The patient received significant postoperative pain relief based on physical and subjective examination. There were no complications or untoward effects related to the technique.

Conclusion Lumbar plexus blockade with continuous local anesthetic infusion via the fascia iliaca compartment is an effective means of providing postoperative analgesia after total knee arthroplasty when epidural analgesia is contraindicated.

  • lumbar plexus
  • total knee arthroplasty
  • local anesthetics
  • fascia iliaca
  • regional anesthesia
  • postoperative pain

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  • Reprint Requests: Stephen R. Longo, M.D., Department of Anesthesia, Hershey Medical Center, P.O. Box 850, Hershey, PA 17033.