Aim: There were acquitted 1105 nerve blocks on 762 patients by means of three methods of peripheral nerves and plexuses identification to compare the safety and efficiency of the methods of regional anesthesia. Methods: Depending on the technique of carrying out the peripheral nerve blocks, patients were divided into 3 groups. 1st group: the identification of the correct placement of the injection needle was done by eliciting paresthesia (572 blocks were performed on 395 patients); 2nd group: an electrical nerve stimulator was used to locate the nerve (164 blocks on 110 patients); 3rd group: the location of the nerve was identified using ultrasonic visual guidance (369 blocks on 257 patients). Results and Conclusion: In 1st group 8 (1.4%) accidental intravascular injections of local anesthetic, 1 case of Horner syndrome (0.17%), 1 case of phrenical nerve were registered. In 17 cases there were performed other methods of anesthesia by reason of inefficiency of the block. In 2nd group 1 case (0.61%) of intravascular injection was noticed. The block was ineffective in single case. There was no complication received in the 3rd group. All the blocks were effective.
The existing researches in the field of regional anesthesia of the sciatic nerve show that if popliteal sciatic nerve blockade is performed, the time of the development of the sciatic nerve anesthesia is longer in comparison with subgluteal sciatic nerve blockade. Background: The aim of the research is to compare the time of the development of the sciatic nerve blockade performed with 1% lidocaine with epinephrine (1:200,000) in subgluteal and popliteal areas under ultrasound guidance. Materials and Methods: Patients were divided into two groups. In Group A (20 patients), the subgluteal approach to block the sciatic nerve was taken; in Group B (20 patients), the popliteal approach was applied. All blockades of the sciatic nerve were performed with 1% lidocaine (30 ml of lidocaine with epinephrine (1:200,000)) and electrical stimulation of peripheral nerves under ultrasound guidance. We measured the time of the development of sensory and motor blocks. Results: In Group A, the sciatic nerve sensory block developed in 15 (14 -16) minutes, a complete motor block developed in 15.5 (15 -17) minutes. In Group B the sciatic nerve sensory block developed in 40 (38.5 -42.5) minutes while a complete motor block did not develop in any patient. Conclusion: When the sciatic nerve is blocked in subgluteal area with 30 ml of 1% lidocaine with epinephrine (1:200,000) under ultrasound guidance, sensory blocks develop faster than during the popliteal blockade: 15 (14 -16) minutes vs. 40 (38.5 -42.5) minutes respectively. The opportunity to define the place of the introduction of local anesthetic in our research is limited.
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