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. 2017 Oct;24(2):115-124.
doi: 10.21454/rjaic.7518.242.prh.

Peripheral nerve blocks and postoperative physical therapy: a single-institution survey of physical therapists' preferences and opinions

Robert L McClain  1 , Steven B Porter  1 , Scott M Arnold  2 , Christopher B Robards  1
Affiliations

Peripheral nerve blocks and postoperative physical therapy: a single-institution survey of physical therapists' preferences and opinions

Robert L McClain et al. Rom J Anaesth Intensive Care. 2017 Oct.

Abstract

Background and aims: Our aim was to ascertain the opinions and preferences of physical therapists with regard to use of peripheral nerve blocks and their impact on the recovery of patients undergoing total joint replacement.

Methods: We conducted an anonymous 24-question survey of 20 full-time inpatient physical therapists at a single tertiary care medical center.

Results: One respondent indicated they never work with patients who have undergone total joint replacement surgery. Nineteen questionnaires were included in the final analysis. Questions omitted by respondents or with write-in answers were not included in the analysis. A majority of respondents (15 [78.9%]) agreed nerve blocks somewhat to greatly improve a patient's pain after total joint replacement surgery. Most respondents answered that nerve blocks somewhat to greatly impede a patient's ability to participate in physical therapy (14 [73.6%]) and make therapy somewhat to very difficult for them as physical therapists (16 [84.2%]). When asked about specific surgeries, (17/18 [94.4%]) and (14/18 [77.8%]) of respondents would prefer that their patients receive periarticular infiltration or no block at all after total knee arthroplasty or total hip arthroplasty, respectively. All respondents (19 [100%]) answered that they thought lower extremity nerve blocks increased a patient's risk of falling after surgery.

Conclusions: According to the physical therapists we surveyed, nerve blocks impede patient recovery and increase the risk of falls, despite their positive impact on pain control. When considering surgery for themselves, therapists indicated they would not want a nerve block.

Keywords: peripheral nerve blocks; physical therapy; postoperative analgesia; postoperative recovery; total joint replacement.

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Conflict of interest statement

Conflict of interest Nothing to declare

Figures

Fig. 1.
Fig. 1.
Color Coded ‘Info-Graphic” of Scalded Likert-type Questions. Respondent 11 indicated that they had never treated patients after total joint surgery and did not complete the survey. PNB indicates peripheral nerve block; Q, question; R, respondent
See this image and copyright information in PMC

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