IMPLEMENTATION OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH FEMORAL NERVE BLOCK AS A DAY-CASE PROCEDURE.

Abstract

Objective: The aim of this prospective observational study was to evaluate the feasibility of performing ACL reconstruction with femoral nerve block as a day-case procedure, implement this change and audit our outcomes.

Methods: From November 2005 to April 2006 all patients undergoing ACL reconstruction were entered into a day-case feasibility study. Any issues preventing day-case discharge were identified, and in November 2006 changes were implemented to address these. Since then all ACL reconstruction patients have been treated as day-cases using femoral nerve blocks. Patients are discharged if safe, and contacted 1 and 7 days postoperatively to detect any problems and to assess patient satisfaction.

Results: 23 patients have followed the day-case pathway, 15 being discharged as day-cases. The other cases had afternoon surgery delaying discharge or surgery in the independent sector where the protocol was not enforced. All patients had good working femoral nerve blocks, were able to mobilise safely and easily with crutches and reported no adverse effects from their blocks at follow-up phone calls. All reported good analgesia at home and high satisfaction with being a day-case.

Conclusions – With appropriate education of patients and staff, ACL reconstruction with femoral nerve block is a safe day-case procedure with high patient satisfaction.