Comparison of sciatic nerve block quality achieved using the anterior and posterior approaches: a randomised trial

Yektaş, Abdülkadir; Balkan, Bedih

doi:10.1186/s12871-019-0898-0

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…A previous study reported a block onset time of 9.42 ± 1.08 min using the anterior approach, 19 while Yektaş et al reported a sensory block onset time of 12.88 ± 4.87 min and a motor block onset time of 13.55 ± 4.75 min, also in patients treated with the anterior approach. 13 In our study, we observed that the sensory and motor block onset times were 5.4 ± 1.9 min and 8.7 ± 3.5 min, respectively, which were shorter compared to those reported in previous studies. However, the differences in the definition of onset time across studies may have contributed to this finding.…”

Section: Discussioncontrasting

confidence: 56%

“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8,12,13 Conventional two-dimensional ultrasound machines are limited in terms of the ability to distinguish the SN from the surrounding tissue, 14 which could affect the success rate and effect of the block procedure. In our study, the image quality of the SN was poor in 8 of the 26 patients (30.8%, visibility score <2).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study

Wang¹,

Qu²,

Deng³

et al. 2023

JPR

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Purpose The location of the sciatic nerve deep within the thigh tissue makes it challenging to locate while the patient is in a supine position. The posterior intermuscular septum of the thigh, which encircles the posterior surface of the adductor magnus muscle (AMM), is where the sciatic nerve is located. Our hypothesis was that administering local anesthetic injections into this area could block the sciatic nerve. Therefore, our aim was to evaluate the effectiveness of sciatic nerve block achieved by injecting local anesthetic into the posterior intermuscular septum of the thigh, named the AMM approach. Methods Twenty-six patients undergoing total knee arthroplasty were included in the study. We performed an ultrasound-guided sciatic nerve block by injecting 20 mL of 0.25% ropivacaine into the posterior surface of the adductor magnus muscle, using the AMM approach. Additionally, we administered a femoral nerve block with 20 mL of 0.4% ropivacaine. We assessed the sensory and motor effects of the blockade in the operated lower limb and recorded postoperative pain scores at 0, 4, 8, 12, 24, and 48 hours after the operation. Results The AMM approach successfully block the sciatic nerve in all 26 patients. The onset of the sensory and motor blockades was achieved within 5.4 ± 1.9 min and 8.7 ± 3.5 min, respectively. We achieved a satisfactory position with the first puncture in 19 of 26 patients (73.1%). The muscle strength of the tibialis anterior immediately after surgery was 4 (ranging from 2 to 5). Additional rescue analgesics were required in 5 of the 26 patients (19.2%) during the first 24 hours postoperatively. Conclusion The AMM approach is an innovative and effective method for sciatic nerve block. When combined with simultaneous femoral nerve block in patients undergoing total knee arthroplasty, it provides a useful analgesic treatment option.

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Section: Discussioncontrasting

confidence: 56%

“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study

Wang¹,

Qu²,

Deng³

et al. 2023

JPR

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“…The incidence of lower extremity fractures is high, and surgery is the mainstay of treatment. However, it can cause hemodynamic fluctuations during surgery, resulting in increased blood pressure and increased heart rate, thereby increasing the risk of surgery in the elderly [ 9 , 10 ], and the anesthesia scheme can directly affect the safety of the surgery and postoperative limb function rehabilitation [ 11 ]. Therefore, the optimal anesthesia protocol for lower limb fracture surgeries remains an important topic.…”

Section: Discussionmentioning

confidence: 99%

Posterior Lumbar Plexus Block Anesthesia for Elderly Patients with Lower Limb Fracture

Xu¹,

Li²,

Wu³

et al. 2022

Disease Markers

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The incidence rate of lower limb fractures is high and has increased over the recent years, which affects the physical and mental health and the daily activities of patients. Lower limb fractures are often treated surgically. Therefore, an effective anesthesia regimen is crucial for a smooth and stable operation. To investigate the efficacy of posterior lumbar plexus block anesthesia during surgery for elderly patients with lower extremity fractures. In total, patients were divided into study and control groups. Anesthesia was administered by posterior lumbar plexus nerve block in the study group and epidural anesthesia in the control group. Hemodynamic parameters, anesthesia condition, pain level (VAS), and adverse effects were measured in both groups before anesthesia (T0), at anesthesia induction (T1), 30 min into the operation (T2), and at the end of the operation (T3). At T0, there were no significant differences in MAP and HR between the study and control groups. However, MAP and HR in the study group were significantly lower than those in the control group at T1, T2, and T3. The BIS value of the study group at each time point after anesthesia was significantly lower than that of the control group. The onset and induction time of anesthesia in the study group were also significantly shorter than those in the control group. Preoperative VAS scores did not differ between the study and control groups. However, the VAS scores of the study group at each time point were significantly lower than those of the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Our results suggest that anesthesia with posterior lumbar plexus block surgery for lower extremity fractures in elderly patients can maintain hemodynamic stability and reduce block onset time, anesthesia induction time, and pain.

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Lower Extremity Nerve Blocks

Subramani

Punia

2020

Blockmate

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Comparison of sciatic nerve block quality achieved using the anterior and posterior approaches: a randomised trial

Cited by 4 publications

References 12 publications

Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study

Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study

Posterior Lumbar Plexus Block Anesthesia for Elderly Patients with Lower Limb Fracture

Lower Extremity Nerve Blocks

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