Delayed appearance of hypaesthesia and paralysis after femoral nerve block

  • Stefan Landgraeber | stefan.landgraeber@uni-due.de Department of Orthopaedics, University of Duisburg-Essen, Germany.
  • Thomas Albrecht Department of Orthopaedics, University of Duisburg-Essen, Germany.
  • Ulrich Reischuck Department of Anaesthesiology, Kliniken Essen-Süd, Essen, Germany.
  • Marius von Knoch Department of Orthopaedics, University of Duisburg-Essen; Department of Anaesthesiology, Kliniken Essen-Süd, Essen, Germany.

Abstract

We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

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Published
2012-03-09
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Section
Brief Reports
Keywords:
regional anesthesia, knee arthroscopy
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How to Cite
Landgraeber, S., Albrecht, T., Reischuck, U., & von Knoch, M. (2012). Delayed appearance of hypaesthesia and paralysis after femoral nerve block. Orthopedic Reviews, 4(1), e8. https://doi.org/10.4081/or.2012.e8