[Continuous blockade of the lumbar plexus ("3-in-1 block") in perioperative pain therapy]

This is a description of a technique for a continuous blockade of the lumbar plexus by means of a specially developed catheter set. The femoral nerve is located more or less atraumatically, on the basis of objective criteria, by the use of a nerve stimulator and a small-lumen puncture cannula. The catheter is subsequently inserted into the fascia surrounding the nerves by the Seldinger technique. The advantage of this catheter technique lies in the fact that the normal blockade period can be extended at will, without any great increase in the amount of time and material needed. Pain therapy for the patient during the operation does not involve the necessity of further punctures with the risk of neural lesion resulting from the fact that partial anaesthesia still exists. Individual dosage is possible because of the anatomical circumstances. The catheter technique we used enabled us in many cases to reduce the amount of local anaesthetic used. No disturbances in the functioning of the bladder or vasomotor system, as is the case with spinal conduction anaesthetics, were observed. In the pre-operative phase this 3-in-1 blockade procedure facilitates the treatment of patients with a fractured collum femoris in particular, and after an operation it makes it possible to mobilize the patient sooner, without the administration of additional analgetics.