Peripheral nerve blocks of the pelvic limb in dogs: A retrospective clinical study

2012 ◽  
Vol 25 (04) ◽  
pp. 314-320 ◽  
Author(s):  
C. Bradbrook ◽  
M. Gurney ◽  
F. Aprea ◽  
L. Clark ◽  
F. Corletto ◽  
...  
Keyword(s):  
Clinical Study ◽  
Peripheral Nerve ◽  
Success Rate ◽  
Orthopaedic Surgery ◽  
Femoral Nerve ◽  
Neurological Complications ◽  
Nerve Blocks ◽  
Retrospective Clinical Study ◽  
Pelvic Limb ◽  
Clinical Records

SummaryObjective: To evaluate the success rate and complications of lumbar plexus (LP) and femoral nerve (FN) blocks, each combined with a sciatic nerve (SN) block, in dogs undergoing pelvic limb orthopaedic surgery.Design: Retrospective clinical study.Procedure: The intra-operative and postoperative clinical records of dogs that underwent orthopaedic surgery of the pelvic limb were reviewed. Dogs were divided into two groups according to the analgesic technique used during surgery: dogs that received a peripheral nerve block (group PNB) and dogs in which opioid analgesia alone was used (group C).Results: The PNB and C groups included 265 and 31 dogs, respectively. Complete statistical analysis was performed in 115/265 dogs of PNB group. The overall success rate of the PNB performed was 77% (89/115): 76% (72/95) and 85% (17/20) for LP-SN and FN-SN blocks, respectively. In group PNB, the prevalence of intra-operative hypotension was 7.8% (9/115). Only one (out of 95 [1.05%]) LP-SN block manifested transient postoperative bilateral pelvic limb paralysis. None of the 265 dogs in group PNB manifested neurological complications at six weeks postoperatively.Conclusion: The success rate and the absence of neurological complications obtained support the use of LP-SN and FN-SN for loco-regional anaesthesia and analgesia in dogs undergoing orthopaedic surgery of the pelvic limb.

Regional anaesthesia of the lower limb

2017 ◽  
Author(s):  
Pawan Gupta ◽  
Anurag Vats
Keyword(s):  
Peripheral Nerve ◽  
Local Anaesthetic ◽  
Lower Limb ◽  
Peripheral Nerves ◽  
Femoral Nerve ◽  
Epidural Haematoma ◽  
Detailed Knowledge ◽  
Success Rates ◽  
Nerve Blocks ◽  
Peripheral Nerve Stimulator

Lower limb nerve blocks gained popularity with the introduction of better nerve localization techniques such as peripheral nerve stimulation and ultrasound. A combination of lower limb peripheral nerve blocks can provide anaesthesia and analgesia of the entire lower limb. Lower limb blocks, as compared to central neuraxial blocks, do not affect blood pressure, can be used in sick patients, provide longer-lasting analgesia, avoid the risk of epidural haematoma or urinary retention, provide better patient satisfaction, and have acceptable success rates in experienced hands. Detailed knowledge of the relevant anatomy is essential before performing any nerve blocks in the lower limb as the nerve plexuses and the peripheral nerves are deep and obscured by bony structures and large muscles. The lumbosacral plexus provides sensory and motor innervation to the superficial tissues, muscles, and bones of the lower limb. This chapter covers different approaches and techniques for lower limb blocks, that is, the lumbar plexus, femoral nerve, fascia iliaca, saphenous nerve, sciatic nerve, popliteal nerve, ankle block, forefoot block, and the intra-articular infusion of local anaesthetics. Both peripheral nerve stimulator- and ultrasound-guided approaches are discussed. The use of ultrasound guidance is suggested as it helps in reducing the dose of local anaesthetic required and can ensure circumferential spread of local anaesthetic around peripheral nerves, which hastens the onset of block and improves success rate.

scholarly journals Ultrasound-Guided Sciatic and Femoral Block in Patient with Recent Embolism Stroke Undergo Amputation Above the Knee

2021 ◽  
Vol 2 (3) ◽  
pp. 116-119
Author(s):  
Propan Hanggada Satyamakti Mubarak ◽  
Keyword(s):  
Peripheral Nerve ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lower Extremities ◽  
Major Surgery ◽  
Anesthetic Technique ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
The Right

Background: Patients undergoing amputation of the lower extremities usually have poor circulation and other comorbidities and, therefore, present a challenge to the anesthesiologist. The combination of sciatic and femoral nerve block is reported to be an effective anesthetic technique for patients undergoing knee surgery, and it is known to be an effective method of postoperative analgesia in patients undergoing major surgery on the subject's lower extremities. Case: A 70-year-old man with a recent embolism stroke, death of his limb on the right cruris region, and underwent an amputation above the knee. Preoperative physical examination showed GCS E4 V, motor aphasia M6, blood pressure 131/82 mmHg, pulse 114 bpm, RR 20 times/minute with bodyweight 70 kg, height 160 cm, SpO2 97%. There was cyanosis in the right cruric region with motor power of 1/5 1/5. The value of leukocytes 18,600/ul, platelets 309,000/ul, Prothrombin Time (PT) 15.8 seconds, Activated partial thromboplastin time (APTT) 25.9 seconds, International normalized ratio (INR) 1,330, neutrophils 81.7%, lymphocytes 12.6%, creatinine 1.8 mg/dl, urea 137 mg /dl, blood sugar at the time 258 mg/dl, Cl 95 mmol/l. This case report suggests that ultrasound-guided peripheral nerve blocks may be useful for major lower extremity surgery in patients with severe hemodynamic impairment. Conclusion: Perioperative management of embolism stroke patients undergoing above-knee amputation requires special attention in selecting anesthetics. Ultrasound-guided peripheral nerve blocks minimize patient hemodynamic changes and provide better postoperative pain control.

Improving Performance by Monitoring the Success Rate of Peripheral Nerve Blocks

2018 ◽  
Vol 126 (2) ◽  
pp. 644-647 ◽  
Author(s):  
Sietske M. K. Bakker ◽  
Rudolf Stienstra
Keyword(s):  
Peripheral Nerve ◽  
Success Rate ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

Peripheral Nerve Blocks for the Lower Extremity

2017 ◽  
Author(s):  
Candace Shavit ◽  
Monica W. Harbell
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Improve Patient Care ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Peripheral Nerve Catheter

Lower extremity peripheral nerve blocks (PNBs) are often used for surgical anesthesia and postoperative pain management. The use of PNB provides improved analgesia, reduced opioid consumption, and improved patient satisfaction and can facilitate earlier rehabilitation and discharge. As the number of lower extremity total joint arthroplasties is projected to increase significantly, the role of peripheral nerve blocks can be expected to grow in similar fashion. With the growing number of procedures and the increasing focus on patient experience and expeditious hospital discharge, PNBs are increasingly recognized as a powerful tool to improve patient care and facilitate recovery after lower extremity surgery. We provide a basic review of regional anesthesia for lower extremity surgical procedures. The widespread availability of ultrasonography has improved the performance and efficacy of PNBs; thus, we focus on ultrasonography-guided procedures. In this review, we discuss pertinent lower extremity anatomy and sonoanatomy, indications, patient outcome measures, techniques, and complications of the most commonly used blocks. This review contains 35 figures, 11 tables, 5 videos, and 103 references.  Key words: adductor canal block, analgesia, ankle block, clinical applications of peripheral nerve blocks, complications of peripheral nerve blocks, continuous peripheral nerve catheter, early ambulation, fascia iliaca compartment block, femoral nerve block, lower extremity nerve blocks, lower extremity regional anesthesia, lumbar plexus block, obturator nerve block, peripheral nerve block, peripheral nerve catheter, popliteal block, psoas compartment block, regional anesthesia, regional anesthesia techniques, saphenous nerve block, sciatic nerve block, ultrasonography guided

scholarly journals Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in Peripheral Nerve Block - Three Prospective Randomized Controlled Studies

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G M Nassif ◽  
B M E Noreldin ◽  
H M M Elazzazi ◽  
F A Abdelmalek ◽  
M M Maarouf
Keyword(s):  
Peripheral Nerve ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Group I ◽  
Group Ii ◽  
Long Acting

Abstract Introduction Peripheral nerve blocks are frequently used as the sole anesthetic technique or as an adjuvant to general anesthesia, However, the duration of sensory nerve block after single doses of long-acting local anesthetics is not consistent enough to avoid the use of postoperative opioids. Many adjuvants have been added to prolong the duration of nerve block, It was recently suggested that, based on current evidence, perineural dexmedetomidine is the most promising adjuvant to extend the duration of long-acting local anesthetics Aim The aim of this work is to study the effects of dexmedetomidine as an adjuvant to bupivacaine in various peripheral nerve blocks. The study will include: supraclavicular brachial plexus block, paravertebral block and femoral nerve block. Patients Adult patients of either sex aged 25 – 60 years, ASA physical status I and II, Elective surgeries appropriate for the nerve block. Methods patients received bupivacaine 0.5% alone in (group I) or bupivacaine 0.5% combined with 100 dexmedetomidine (group II) in peripheral nerve blocks. Motor and sensory block onset times; durations of blockades and analgesia were recorded Results Sensory and motor block onset times were shorter in group II than in group I. Sensory and motor blockade durations were longer in group II than in group I. Duration of analgesia was longer in group II than in group I. Systolic, diastolic arterial blood pressure levels, and heart rate were less in group II. Conclusion In the current study, it was obvious that:(Addition of dexmedetomidine to bupivacaine in supraclavicular nerve block, paravertebral nerve block and femoral nerve block has shortened the onset times of both sensory and motor blocks and significantly prolonged their durations, Dexmedetomidine had also the added effect of sedation with minimal side effects, which makes it a beneficial adjuvant to local anesthetics in peripheral nerve blocks, Addition of dexmedetomidine to bupivacaine prolonged the postoperative analgesia with subsequent consumption of less amount of analgesics and The use of ultrasonography in performing nerve blocks significantly reduced the incidence of complications such as pneumothorax or intra-arterial injection and hence, lowered the incidence of systemic toxicity of local anesthetics).

scholarly journals Continuous Peripheral Nerve Blocks

2010 ◽  
Vol 112 (2) ◽  
pp. 347-354 ◽  
Author(s):  
Brian M. Ilfeld ◽  
Lisa K. Moeller ◽  
Edward R. Mariano ◽  
Vanessa J. Loland ◽  
Jennifer E. Stevens-Lapsley ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Femoral Nerve ◽  
Lumbar Plexus ◽  
Nerve Blocks ◽  
Maximum Voluntary Isometric Contraction ◽  
Ambulatory Ability ◽  
Anesthetic Concentration ◽  
Secondary Endpoints

Background The main determinant of continuous peripheral nerve block effects--local anesthetic concentration and volume or simply total drug dose--remains unknown. Methods We compared two different concentrations and basal rates of ropivacaine--but at equivalent total doses--for continuous posterior lumbar plexus blocks after hip arthroplasty. Preoperatively, a psoas compartment perineural catheter was inserted. Postoperatively, patients were randomly assigned to receive perineural ropivacaine of either 0.1% (basal 12 ml/h, bolus 4 ml) or 0.4% (basal 3 ml/h, bolus 1 ml) for at least 48 h. Therefore, both groups received 12 mg of ropivacaine each hour with a possible addition of 4 mg every 30 min via a patient-controlled bolus dose. The primary endpoint was the difference in maximum voluntary isometric contraction (MVIC) of the ipsilateral quadriceps the morning after surgery, compared with the preoperative MVIC, expressed as a percentage of the preoperative MVIC. Secondary endpoints included hip adductor and hip flexor MVIC, sensory levels in the femoral nerve distribution, hip range-of-motion, ambulatory ability, pain scores, and ropivacaine consumption. Results Quadriceps MVIC for patients receiving 0.1% ropivacaine (n = 26) declined by a mean (SE) of 64.1% (6.4) versus 68.0% (5.4) for patients receiving 0.4% ropivacaine (n = 24) between the preoperative period and the day after surgery (95% CI for group difference: -8.0-14.4%; P = 0.70). Similarly, the groups were found to be equivalent with respect to secondary endpoints. Conclusions For continuous posterior lumbar plexus blocks, local anesthetic concentration and volume do not influence nerve block characteristics, suggesting that local anesthetic dose (mass) is the primary determinant of perineural infusion effects.

Sign in / Sign up

Export Citation Format

Share Document