Review on Clinical Research Progress of B-ultrasound-guided Nerve Block Anesthesia for Lower Limb Surgery

Background: Co-administration of drugs with synergistic effects is considered as one of the methods to increase the effectiveness of intrathecal anesthesia and to reduce the need for injectable analgesics. The purpose of this study was to investigate the efficacy of intrathecal midazolam on enhancing the analgesic effect of fentanyl in patients undergoing lower limb surgery. Materials: The present double-blinded clinical trial was conducted on 90 candidate patients undergoing lower limb orthopedic surgery in 2017 at Khatam-Al-Anbiya Hospital in the city of Zahedan, Iran. To this end, the patients were selected via convenience sampling method and then randomly divided into three groups. Afterwards, 3 cc of 0.5% hyperbaric Marcaine was injected intrathecally in the first group, 3 cc of Marcaine + 25 ug of fentanyl was administered to the second group, and 3 cc of Marcaine + 25 ug of fentanyl + 1 mg of midazolam was administered to the third group (the final volume of all three syringes was brought up to 3.7 cc with normal saline). The duration of sensory nerve block and those of motor block and analgesia, as well as changes in vital signs, were then measured in these groups. Moreover, the data were analyzed using SPSS Statistics (Version 22.0) through Chi-square test and one-way analysis of variance (ANOVA). Results: The mean age and gender distribution of the patients in the three study groups did not differ significantly. The mean duration of sensory nerve block was equal to 98.6+/-11.1 min in the first group, 142.2+/-12.4 min in the second group, and 174.3+/-10.9 min in the third group; all showed a statistically significant difference (P=0.0001, P=0.001, P=0.000).The mean duration of analgesia was also reported to be 204.43+/-0.3 min in the first group, 323.62+/-7.4 min in the second group, and 526.22+/-0.9 min in the third group, indicating a statistically significant difference between the three study groups (P=0.0001, P=0.000, P=000). Conclusion: The results of this study demonstrated that adding midazolam to intrathecal fentanyl could significantly increase the duration of sensory nerve block and that of post-operative analgesia.

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Role of ultrasound guided epidural anesthesia for lower limb surgery in children with previously repaired meningomyelocele

Pediatric Anesthesia ◽

10.1111/pan.13297 ◽

2017 ◽

Vol 28 (3) ◽

pp. 287-290 ◽

Cited By ~ 1

Author(s):

Vrushali C. Ponde ◽

Vinit V. Bedekar ◽

Dilip Chavan ◽

Anuya Gursale ◽

Dipal Shah

Keyword(s):

Epidural Anesthesia ◽

Lower Limb ◽

Ultrasound Guided ◽

Lower Limb Surgery

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Combined psoas compartment and sciatic nerve block for lower limb surgery: An alternative anesthetic option in high-risk geriatric patients

Karnataka Anaesthesia Journal ◽

10.4103/2394-6954.163090 ◽

2015 ◽

Vol 1 (2) ◽

pp. 85

Author(s):

Sunny Malik ◽

Deepak Krishna ◽

Shraddha Malik

Keyword(s):

High Risk ◽

Sciatic Nerve ◽

Nerve Block ◽

Lower Limb ◽

Geriatric Patients ◽

Sciatic Nerve Block ◽

Lower Limb Surgery

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S31 THE VAS SCORE IN APICAL PERIPROSTATIC NERVE BLOCK ANESTHESIA VERSUS PLACEBO IN TRANSRECTAL ULTRASOUND GUIDED BIOPSY

European Urology Supplements ◽

10.1016/s1569-9056(11)61472-3 ◽

2011 ◽

Vol 10 (9) ◽

pp. 584

Author(s):

I. Arvanitis ◽

T. Granitsas ◽

M. Platanas ◽

N. Ferakis ◽

P. Anastasopoulos ◽

...

Keyword(s):

Nerve Block ◽

Transrectal Ultrasound ◽

Ultrasound Guided ◽

Vas Score ◽

Guided Biopsy ◽

Nerve Block Anesthesia ◽

Periprostatic Nerve Block ◽

Ultrasound Guided Biopsy

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Successful use of ultrasound-guided peripheral nerve block for lower limb surgery in a patient with heart failure with reduced ejection fraction: a case report

Journal of International Medical Research ◽

10.1177/03000605211045230 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110452

Author(s):

Jaewoong Jung ◽

Misoon Lee ◽

Yang-Hoon Chung ◽

Sung-Hwan Cho

Keyword(s):

Heart Failure ◽

Sciatic Nerve ◽

Ejection Fraction ◽

Peripheral Nerve ◽

Lower Limb ◽

Peripheral Nerve Block ◽

Ultrasound Guided ◽

Reduced Ejection Fraction ◽

Lower Limb Surgery ◽

Fascia Iliaca Compartment Block

The number of patients with heart failure with reduced ejection fraction (HFrEF) is increasing. These patients have a reduced cardiorespiratory reserve. Therefore, preoperative evaluation is essential to determine the best type of anaesthesia to use in patients with HFrEF. A 70-year-old man with HFrEF was scheduled to undergo debridement of skin necrosis due to thrombotic occlusion of the right common iliac artery. He had undergone wound dressing changes under local anaesthesia every other day for several months, and treatment for heart failure was on-going. A sciatic nerve and fascia iliaca compartment block was performed under ultrasound guidance because of the patient’s cardiopulmonary function. After confirming adequate sensory blockage, surgery was performed without any haemodynamic instability or complications. Thereafter, debridement was performed twice more using the same block technique, and a skin autograft was also successfully performed. We successfully performed an ultrasound-guided sciatic nerve and fascia iliaca compartment block in a patient with HFrEF who was scheduled to undergo lower limb surgery. Peripheral nerve block is an alternative option for patients with HFrEF.

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Comparison of Ultrasound Guided Ankle Block versus Anatomical Landmark Guided Ankle Block in Minor Ankle and Foot Surgeries

10.53350/pjmhs2115113484 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3484-3487

Author(s):

Muhammad Nawaz Anjum ◽

Wajeeha Mufti ◽

Yasser Athar Shah ◽

Irfan Ali

Keyword(s):

Success Rate ◽

Regional Anesthesia ◽

Lower Limb ◽

Local Population ◽

Anatomical Landmark ◽

Anatomical Landmarks ◽

Block Group ◽

Ultrasound Guided ◽

Anatomic Landmark ◽

Lower Limb Surgery

Background: Regional anesthesia has increasingly expanded its role in perioperative care of patients undergoing foot and ankle surgery. The use of regional anesthesia has been widely implemented among anesthesiologists and pain providers. Multiple approaches for sephanous nerve blockade have been used including nerve stimulation, anatomical landmarks and ultrasound. It has been observed in previous studies that USG ankle block is more successful as compared to conventional anatomical landmark guided nerve block; so this study was planned to get precise and reliable results regarding both techniques in our local population. Objective: To compare the methods of surgical anesthesia of Ultrasound-guided ankle block versus conventional anatomic landmark-guided techniques in lower limb surgery under regional anesthesia. Materials and methods: This randomized control was carried out at Department of Anesthesia Mayo Hospital Lahore. After meeting the inclusion and exclusion criteria 50 patients (25 in each group ) were enrolled. Patients were randomly divided into two groups using lottery method. Group A patients underwent USG ankle block while group B patients underwent conventional anatomic landmark guided ankle block. Results: Mean age of patients was 46.96±11.578 years; 40(80%) patients were male and 10(20%) patients were females. Successful anesthesia was achieved in 42 (84%) patients; in which in USG block group the successful anesthesia was achieved in 22(88%) patients and in ALG block group successful anesthesia was achieved in 20(80%) patients (p value =0.702) Conclusion : Findings of this study conclude that both techniques have statistically insignificant difference in terms of success rate , however USG ankle block for surgical anesthesia showed higher success rate as compared to anatomic landmark guided technique in lower limb surgery under regional anesthesia. Keywords: Ultrasound-guided Ankle Block, Anatomic Landmark-guided Ankle Block, Lower limb surgery.

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