Sciatic Nerve Block via  Posterior Labat Approach Is More Efficient Than Lateral Popliteal Approach Using a Double-injection Technique

2004 ◽  
Vol 101 (1) ◽  
pp. 138-142 ◽  
Author(s):  
Manuel Taboada ◽  
Jaime Rodríguez ◽  
Julián Álvarez ◽  
Joaquín Cortés ◽  
Francisco Gude ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Success Rate ◽  
Nerve Block ◽  
Onset Time ◽  
Sciatic Nerve Block ◽  
Injection Technique ◽  
Motor Blockade ◽  
General Anesthetic ◽  
Nerve Blockade ◽  
Double Injection

Background For peripheral nerve blockade, the double-injection technique proved to be superior to a single injection in previous investigations. The current study was designed to compare onset time and efficacy of two different double-injection approaches for sciatic nerve block with 0.75% ropivacaine. Methods A total of 50 patients undergoing foot surgery were randomly assigned to receive sciatic nerve blockade by means of the classic (Labat) posterior approach (n = 25) or a lateral popliteal approach (n = 25). All blocks were performed with the use of a nerve stimulator, and both major components of the sciatic nerve (tibial and common peroneal nerves) received separately 10 ml ropivacaine, 0.75%. Success rate was defined as a complete sensory and motor block associated with pain-free surgery. Results A greater success rate was observed in the classic group (96%) as compared with the popliteal group (68%; P < 0.05). A general anesthetic became necessary in six patients (24%) with the lateral popliteal approach and none with the classic approach (P < 0.05). The onset of complete sensory and motor blockade was significantly faster in the classic group (12 +/- 6 min) as compared with the popliteal group (26 +/- 10 min; P < 0.05). Conclusion A double injection with a relatively low volume of 0.75% ropivacaine generated a higher success rate and a shorter onset time of sensory and motor blockade after the classic Labat approach than after a lateral popliteal approach.

Effect of Local Anesthetic Dilution on the Onset Time and Duration of Double-Injection Sciatic Nerve Block

2015 ◽  
Vol 59 (6) ◽  
pp. 287-288
Author(s):  
Gianluca Cappelleri ◽  
Andrea Luigi Ambrosoli ◽  
Stefania Turconi ◽  
Marco Gemma ◽  
Erika Basso Ricci ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Onset Time ◽  
Sciatic Nerve Block ◽  
Double Injection

Comparison of the Parasacral Approach and the Posterior Approach, with Single- and Double-Injection Techniques, to Block the Sciatic Nerve

2003 ◽  
Vol 98 (6) ◽  
pp. 1436-1441 ◽  
Author(s):  
Philippe Cuvillon ◽  
Jacques Ripart ◽  
Pascal Jeannes ◽  
Aba Mahamat ◽  
Christophe Boisson ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Single Injection ◽  
Onset Time ◽  
Sciatic Nerve Block ◽  
Success Rates ◽  
Posterior Superior Iliac Spine ◽  
Similar Time ◽  
Double Injection ◽  
Injection Group

Background The purpose of this study was to compare parasacral and Winnie's single- or double-injection approaches for sciatic nerve block. Methods One hundred fifty adults scheduled to undergo lower limb surgery were randomized to receive on the sciatic nerve 20 ml ropivacaine, 0.75%: single bolus for parasacral and Winnie's single injection. For Winnie's double injection, the peroneal and tibial nerves received separately 10 ml plus 10 ml. Blocks were performed with the use of nerve stimulator (intensity < 0.5 mA, 1 Hz). For the parasacral method, a line was drawn between the posterior superior iliac spine and the ischial tuberosity; needle entry was at 6 cm inferior to the posterior superior iliac spine. Results The groups were similar. Time to perform the block was 2 (1-5) min for the parasacral method, with no difference from Winnie's single injection (3 [1-10] min), but was shorter with double injection (5.5 [2-15] min) (P = 0.0001). Onset of sensory block was similar in the parasacral (25 [7.5-50] min) and Winnie single-injection groups (25 [5-50] min) but significantly longer in the double-injection group (15 [5-50] min). Success rates for complete block were similar in the parasacral (66%) and Winnie's double-injection groups (68%) after 30 min but higher in the Winnie's single-injection group for tibial sensory and motor block (48%) (P < 0.017). Conclusion Time to perform a parasacral block was short, and the parasacral approach had a high success rate and a short onset time. Therefore, this block might be a useful alternative to Winnie's modification for sciatic nerve block.

scholarly journals Comparison between the Use of bupivacaine 0.5%alone and bupivacaine 0.5% with nefopam 20mg in sciatic n block ( popliteal approach) and femoral n block in patients undergoing below knee surgery

2020 ◽  
Vol 16 (1) ◽  
pp. 52-61
Author(s):  
Khaled Ali Khaleel
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Normal Saline ◽  
Lower Limb ◽  
Onset Time ◽  
Knee Surgery ◽  
Sciatic Nerve Block ◽  
Motor Blockade ◽  
Time Duration ◽  
Duration Of Action

Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.Methods: 100 patients with American society of anesthesiologists (ASA) 2 / 3/4 patients between 25 and 85 years who underwent elective and emergency lower limb surgeries randomly allocated into two group, each group has 50 patients by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine with 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (20mg) of Nefopam in the second group (Group BN). The onset time, duration time of both sensory and motor blocking were seen and compared between the two groups.Results : The onset time of both sensory and motor blockade was shorter in Group BN (bupivacaine with nefopam) when compared to Group BS (bupivacaine and normal saline) (p<0.0001). The duration of both sensory and motor blockade was longer in Group BN when compared to Group BS (p<0.0001). There were no significant hemodynamic changes (PR, BP,SPO2) in both groups. Also there is no any side effect or any complication.Conclusion Nefopam when mixed with Bupivacaine in Sciatic nerve block and femoral nerve block in below knee surgeries shortens the onset time and prolongs the duration of action of both sensory and motor blockade without any systemic side effects and give excellent intra and postoperative analgesia.

Lateral Sciatic Nerve Block at the Knee-Single or Double Injection Technique ?

2002 ◽  
Vol 96 (Sup 2) ◽  
pp. A867
Author(s):  
Ralf E. Gebhard ◽  
Maria E. Matuszczak ◽  
Didier A. Sciard ◽  
Danuta Kocieniewska ◽  
Navtej Tung
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Sciatic Nerve Block ◽  
Injection Technique ◽  
Double Injection

Effect of Local Anesthetic Dilution on the Onset Time and Duration of Double-Injection Sciatic Nerve Block

2014 ◽  
Vol 119 (2) ◽  
pp. 489-493 ◽  
Author(s):  
Gianluca Cappelleri ◽  
Andrea Luigi Ambrosoli ◽  
Stefania Turconi ◽  
Marco Gemma ◽  
Erika Basso Ricci ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Onset Time ◽  
Sciatic Nerve Block ◽  
Double Injection

scholarly journals Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Shoji Nishio ◽  
Shigeo Fukunishi ◽  
Tomokazu Fukui ◽  
Yuki Fujihara ◽  
Shohei Okahisa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Total Hip Arthroplasty ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Sciatic Nerve Block ◽  
Nerve Blockade ◽  
Continuous Femoral Nerve Block

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

scholarly journals Efficacy of perineural versus systemic dexamethasone in prolonging analgesia after ultrasound guided femoral and sciatic nerve block for patients undergoing below knee surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Abdelaziz ◽  
H M Elzahaby ◽  
A A Elshebeiny ◽  
D M Heiba
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Onset Time ◽  
Analgesic Efficacy ◽  
Sensory Block ◽  
Postoperative Pain Management ◽  
Sciatic Nerve Block ◽  
Dexamethasone Group ◽  
Significant Difference ◽  
Group B

Abstract Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Objective to compare the analgesic efficacy of both, intravenous and perineural administration of dexamethasone during femoral and sciatic nerve block using bupivacaine in patients undergoing below knee surgeries. Patients and Methods In our study, 50 patients were randomly divided into two equal groups: Group A (Perineural Dexamethasone group) [n = 25]: Those cases received 2ml volume of dexamethasone (8mg) combined with the 20 ml of bupivacaine of 0.5% concentration in each block, followed by injecting 5 ml saline intravenous. Group B (Systemic Dexamethasone group) [n = 25]: Those cases received 2 ml of dexamethasone (8mg) diluted over 3 cm saline in a 5 ml syringe following injection of the perineural 20 ml bupivacaine (0.5%) combined with 2 ml saline to have the same syringe volume for each block. Results Our study showed that onset time for sensory block was (25.39 ± 3.79) mins for systemic group and (18.85 ± 4.11) mins in perineural group with a significant statistical difference (P &lt; 0.001) between both groups as the onset of sensory block in perineural group was significantly shorter than the systemic group and the duration of sensory block was (650.00 ± 62.8) mins in systemic group and (718.52 ± 62.06) mins in perineural group. The duration of sensory block was significantly shorter in systemic group than in perineural group with statistically high significant difference between groups (P &lt; 0.001). Onset time for motor block was (30.61 ± 4.89) mins in systemic group and (27.59 ± 3.31) mins in perineural group. Perineural group had shorter time of onset than systemic dexamethasone group with a significant difference between groups (P = 0.013). The duration of analgesia was significantly longer in perineural group than systemic group (P &lt; 0.001) Conclusion Dexamethasone was seen to be a potent adjunct to local anesthetic to prolong post operative analgesia with negligible side effects & better outcome to the perineural route.

Sign in / Sign up

Export Citation Format

Share Document