The '3 in 1' lumbar plexus block following anterior cruciate ligament reconstruction with autologous hamstring...

We have reviewed 33 patients undergoing primary reconstruction of the anterior cruciate ligament with a four-strand hamstring graft to assess the analgesic effect of a '3 in 1' lumbar plexus block. Patients were randomised into two groups to determine whether or not they received a catheter infusion of bupivacaine for 24 h after operation. Pain scores and additional analgesic requirements were assessed at 4, 8, 12, 16, 20 and 24 h after surgery. No difference was found between the two groups in terms of pain scores (P=0.884) and the numbers requiring morphine were similar (5/16 and 7/17). There was a trend (2.0 vs. 3.4 tablets) towards a greater coproxamol requirement for the non-block group, although not quite statistically significant (P=0.06). We conclude that the additional risk and cost of '3 in 1' lumbar plexus blockade is not justifiable after this procedure.