Vastus lateralis nerve block for knee hardware removal.

Abstract

Effective pain management post-knee surgery is critical for recovery and minimizing opioid use. We present a case of a patient undergoing ORIF for a comminuted patellar fracture and subsequent hardware removal because of persistent medial knee pain from hardware prominence. Despite initial opioid administration under general anesthesia, severe postoperative pain necessitated rescue with peripheral nerve blocks. Adductor canal, anterior femoral cutaneous, and vastus lateralis blocks provided significant pain relief without additional opioids. This approach reduces systemic opioid exposure, crucial in the current opioid crisis. Peripheral nerve blocks, especially the vastus lateralis block, effectively managed severe postoperative pain, highlighting their role in opioid-sparing strategies. These findings advocate for the broader adoption of regional anesthesia to enhance perioperative outcomes amid opioid-related challenges while supporting early mobilization and rehabilitation.