scholarly journals Sciatic Nerve and Lumbar Plexus Block for Below Knee Amputation- Newer Approach for Better Haemodynamic Stability and Patient Safety

2021 ◽  
Author(s):  
Jigisha Bharatbhai Mehta ◽  
Ganesh Naik ◽  
Dinesh Chauhan
Keyword(s):  
Patient Safety ◽  
Sciatic Nerve ◽  
Regional Blood Flow ◽  
Present Report ◽  
Lumbar Plexus ◽  
Nerve Blocks ◽  
Knee Amputation ◽  
Haemodynamic Stability ◽  
Lumbar Plexus Block ◽  
Plexus Block

Patients undergoing lower extremity amputation may have multiple co-morbid conditions like diabetes, cardiovascular, hepatic and renal disorders and are at risk of perioperative mortality and morbidity. Peripheral nerve blocks are associated with minimal haemodynamic changes, improved regional blood flow and are ideal for high risk patients who cannot tolerate slightest attenuation in haemodynamic response. The present report is of a 50-year-old female patient admitted for below knee amputation surgery. Sciatic nerve and lumbar plexus block were the mode of anaesthesia. It was found that regional anaesthesia in the form of nerve block provided adequate anaesthesia and analgesia, provided greater haemodynamic stability and patient safety.

scholarly journals Comparison of Parasacral and Posterior Sciatic Nerve Blocks Combined with Lumbar Plexus Block

2013 ◽  
Vol 41 (5) ◽  
pp. 171-174 ◽  
Author(s):  
Ertan Ozturk ◽  
Ismail Gokyar ◽  
Berrin Gunaydin ◽  
Hulya Celebi ◽  
Avni Babacan ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Lumbar Plexus ◽  
Nerve Blocks ◽  
Lumbar Plexus Block ◽  
Plexus Block

scholarly journals Continuous Lumbar Plexus Block under the Guidance of the “Shamrock Method” Ultrasound: Analgesic Effects and Hemodynamic Effects after Total Knee Arthroplasty in Elderly Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jinpei Xue ◽  
Xiang Fu ◽  
Zurong Hu
Keyword(s):  
Elderly Patients ◽  
Shear Viscosity ◽  
Whole Blood ◽  
Sensory Nerve ◽  
Onset Time ◽  
Plasma Viscosity ◽  
Lumbar Plexus ◽  
Nerve Blocks ◽  
Lumbar Plexus Block ◽  
Plexus Block

Objective. To explore the effect of continuous lumbar plexus block guided by the “Shamrock method” on postoperative analgesia and hemodynamics in elderly patients after total knee arthroplasty (TKA). Methods. From January 2020 to December 2020 in our hospital, 98 patients who underwent TKA were selected. Using the random number table method, the patients were divided into two groups: a continuous lumbar plexus block group (group L), with 49 patients, and a continuous femoral nerve block group (group F), with 49 patients. The onset time and maintenance time of motor and sensory nerve blocks in patients were recorded. A visual analogue scale (VAS) was applied to assess the pain severity at 6, 12, 24, and 48 h after the operation. The VAS score (FVAS) was applied to evaluate the pain severity of the patients during 24 and 48 h after the operation and knee joint functional exercise. The levels of hemodynamic indexes such as heart rate, mean arterial pressure, and oxyhemoglobin saturation and the levels of hemorheological indexes such as plasma viscosity, high and low whole blood shear viscosity, fibrinogen, and hematocrit were detected and compared between the two groups immediately after the operation and at 12 h and 48 h after the operation, respectively. The incidence of adverse reactions induced by anesthesia was counted. Results. The onset time of motor and sensory nerve blocks in group L was lower than that in group F, and the maintenance time was higher than that in group F ( P < 0.05 ). The VAS scores of 6, 12, 24, and 48 h after operation in group L were significantly lower than those in group F ( P < 0.05 ). The FVAS scores of group L at 24 and 48 h after operation were significantly lower than those of group F ( P < 0.05 ). The heart rates of the patients in the two groups were higher at 12 h and 48 h after operation than those immediately after operation ( P < 0.05 ). The heart rates at 12 h and 48 h after operation in group L were lower than those in group F ( P < 0.05 ). The plasma viscosity, high whole blood shear viscosity, and low whole blood shear viscosity in the group L at 12 h and 48 h after operation were lower than those in group F ( P < 0.05 ). There was no significant difference in the incidence of local anesthetic poisoning, nausea, vomiting, urinary retention, pruritus, and other adverse reactions between the two groups ( P > 0.05 ). Conclusion. The “Shamrock method” ultrasound-guided continuous lumbar plexus block in elderly patients after TKA has good analgesic effect, stable hemodynamics, little influence on hemorheology, and good safety. It is of great value to enhance the surgical effect and promote postoperative rehabilitation.

scholarly journals The Comparing of Ultrasound-guided Techniques: Sciatic Block with Continuous Lumbar Plexus Block or Continuous Femoral Nerve Block for Anesthesia and Analgesia of Total knee Replacement

2013 ◽  
Vol 7 (1) ◽  
pp. 19-25
Author(s):  
M. Dauri ◽  
S. Faria ◽  
L. Celidonio ◽  
P. David ◽  
A. Bianco ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lumbar Plexus ◽  
Ultrasound Guided ◽  
Lumbar Plexus Block ◽  
Total Knee ◽  
Plexus Block

Background and Aims: This double blind prospective randomized clinical trial evaluated the efficacy and safety of continuous ultrasound-guided lumbar plexus block compared to continuous ultrasound-guided femoral nerve block, in the intra-operative and postoperative periods after total knee replacement. Methods: Forty ASA I-III patients were randomized to receive: continuous femoral block (n= 20, 30 ml of ropivacaine 5 mg/ml) or continuous lumbar plexus block (n= 20, 30 ml of ropivacaine 5 mg/ml) both in association with single injection sciatic nerve block. All patients received continuous infusion of 2 mg/ml of ropivacaine at 8 ml/h for 48 hours and intravenous morphine for patient-controlled analgesia. Primary outcomes were intra-operative sufentanil consumption and verbal analogue scale (VAS) score at rest at 24h follow up. Results: Intra-operative sufentanil consumption was higher in the femoral block (FEM) group compared to the lumbar plexus block (PSOAS) group (FEM: 10.00 (10.00, 17.50) µg; PSOAS: 2.50 (0.00, 10.00) µg. p= 0.002). Obturator motor blockade occurred more frequently in the PSOAS group (70%) than in the FEM group (40%) (p=0.1); however, we found no differences in sensory blockade (p=0.6). VAS at rest was similar in the two groups at 24h postoperatively (FEM: 29.50 ± 14.74 mm; PSOAS: 25.60 ±17.42 mm. p=0.4), and throughout the follow-up period. No differences were detected in pain scores during physiotherapy. Conclusion: Continuous femoral and lumbar plexus blocks, both in association with sciatic nerve block, provided similar VAS scores at 24h, and throughout the follow-up period; intra-operative sufentanil consumption was, however, lower in the lumbar plexus block group.

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