You are here

Article Text

Article menu
Download PDFPDF
ePoster session 2 – Station 1
EP049 Lower extremity enhanced nerve analgesia (LEENA): a novel 4-in-1 peripheral nerve block of the lower extremity
  1. Walid Alrayashi1,
  2. Miheer Sane2,
  3. Hanna Van Pelt2,
  4. Conor McGinn3 and
  5. Steven Staffa1
  1. 1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, USA
  2. 2Anesthesiology, Critical Care, Pain Medicine, Harvard Medical School, Boston, USA
  3. 3Anesthesiology, Critical Care, Pain Medicine, Boston Children’s Hospital, Boston, USA

Abstract

Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Background and Aims Femoral, sciatic, obturator, and lateral femoral cutaneous blocks have been used individually, but combined, they can provide more effective pain relief (1-3). Combination often requires multiple needle sticks, position changes, and increased time. We developed a novel 4-in-1 block, we are calling LEENA, to target all of these nerves from a single insertion site and aim to compare this to the more conventional adductor canal block.

Methods This is a retrospective cohort study of patients undergoing lower extremity surgeries which compared patients that received the LEENA block versus a traditional adductor canal (AC) block. Matching was performed for age, weight, gender, ASA, medications used, and surgical procedure. Our primary outcomes were block time, perioperative opioids, pain scores, and strength testing 2 weeks after surgery. Data was analyzed using Stata and P values were calculated using the Wilcoxon rank sum, the Chi-square, or Fisher’s exact test.

Results 62 patients received the LEENA block and were matched with 177 controls for a total of 239 patients. Baseline demographics were not different. The LEENA group received less opioids, had lower pain score, and required less ventilation support. Strength testing was also significantly better in the LEENA group compared to the controls 2 weeks after surgery.

View this table:
Abstract EP049 Table 1

Demographics, primary, and secondary outcomes

Abstract EP049 Figure 1
Abstract EP049 Figure 1

US image. Structures not highlighted

Abstract EP049 Figure 2
Abstract EP049 Figure 2

US image of block highlighted. FN: femoral nerve, LFCN: lateral femoral cutaneous nerve, S: sciatic nerve

Conclusions The LEENA block patients had better analgesia, avoided airway manipulation in 15% of cases, and potentially improved functional outcomes two weeks after surgery. The novel block is feasible and may have significant advantages compared to the adductor canal block alone. Prospective studies are needed to study this novel approach further.

  • Regional anesthesia
  • adolescent
  • nerve blocks
  • novel approaches.

https://doi.org/10.1136/rapm-2024-ESRA.122

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.