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Falls Associated with Lower-Extremity-Nerve Blocks: A Pilot Investigation of Mechanisms
  1. Samuel I. Muraskin, M.D.,
  2. Bryan Conrad, M.Eng.,
  3. Naiquan Zheng, Ph.D.,
  4. Timothy E. Morey, M.D. and
  5. Kayser F. Enneking, M.D.
  1. Department of Anesthesiology, University of Florida, Gainesville, Florida
  2. Department of Orthopedics and Rehabilitative Medicine, University of Florida, Gainesville, Florida
  3. Biomechanics/Motion Analysis Laboratory, University of Florida, Gainesville, Florida
  1. Reprint requests: F. Kayser Enneking, M.D., Department of Anesthesiology, PO Box 100254, Gainesville, FL 32610-0254. E-mail: kenneking{at}anest.ufl.edu

Abstract

Objective: Documented falls after lower-extremity-nerve blocks are rare. We believe this paucity of documented falls is the result of underreporting and the lack of serious complications resulting from these falls. In addition, the mechanism(s) for falls after lower-extremity-nerve blocks has not been elucidated.

Case Reports: These reports highlight the mechanism of fall in a patient with a femoral-nerve block (FNB) and in a patient with a femoral-nerve and sciatic-nerve block (FNB/SNB). In addition, we report our findings when volunteers underwent FNB, sciatic-nerve block (SNB) and FNB/SNB and were studied in a gait-analysis laboratory.

Conclusions: Lower-extremity-nerve blocks result in decreased leg stiffness and lateral instability, which may lead to difficulty with pivoting maneuvers.

  • Femoral-nerve block
  • Sciatic-nerve block
  • Femoral-sciatic-nerve block
  • Falls
  • Postoperative complications
  • Balance after surgery

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Footnotes

  • Supported by the Departments of Anesthesiology and Orthopaedics and Rehabilitative Medicine, College of Medicine, University of Florida, Gainesville, FL.

    Presented in abstract form at the American Society of Regional Anesthesia, Palm Springs, CA, April 6, 2006, and at the Association of University Anesthesiologists, Tucson, AZ, May 11, 2006.

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