Continuous Parasacral Sciatic Block: A Radiographic Study

Abstract

The parasacral sciatic block results in a frequent success rate of blockade of all three major components of the sciatic plexus (tibial, common peroneal, and cutaneous nerve of thigh). A contrast radiography can be used to confirm the proper position of the catheter.

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

“…Significantly, successful continuous PNB does not seem to be affected by the distance the catheter is threaded beyond the needle tip, [15][16][17] but catheters threaded a shorter distance (0-1 cm) tend to dislodge more frequently, 17 suggesting that a balance must be achieved between accurate catheter placement and catheter stability. Our results show that a more than sixfold greater holding force was exerted on CON catheters, which is a significant difference (Fig.…”

Volumes anestésicos efetivos no bloqueio do nervo isquiático: comparação entre as abordagens parassacral e infraglútea-arabiceptal com bupivacaína a 0,5% com adrenalina e ropivacaína a 0,5%

“…In the infragluteal region, both branches are separated from each other, but they are still within one common epineural sheath 19 . Due to this anatomical characteristic, the parasacral approach is frequently successful and the local anesthetic has a predictable dispersion through the sheath of the sciatic nerve with a single injection of a relatively small volume through the sacral compartment fascia 12 . However, in the infraglutealparabiceps approach, double injection guarantees faster onset of action and better quality of the neural blockade in both terminations of the sciatic nerve, allowing greater proximity of the injection to its site of action 4,5,20,21 .…”

“…The end of the administration of the anesthetic in the second injection site was considered moment zero for the evaluation of the blockade effectivity. For the parasacral SNB, a line was drawn from the posterior superior iliac spine (PSIS) to the ischial tuberosity (IT); the needle was inserted 6 cm caudal to the PSIS 12,13 . After infiltrating the skin with 2 mL of 1% lidocaine with a 38-mm, 25G needle, a 100-mm, 21G peripheral neurostimulation needle (Stimuplex A100, BBraun, Melsungen, Germany) connected to the same neurostimulator (Stimuplex Dig, EC, BBraun, Melsungen, Germany) was inserted in the sagittal plane with a subtle caudal angulation (10°).…”

Perbandingan Pemberian 20 mL dengan 30 mL Bupivakain 0,5% terhadap Mula Kerja dan Lama Kerja Blokade Saraf Iskiadikus Pendekatan Parasakral Menggunakan Alat Stimulasi Saraf pada Operasi Ekstremitas Bawah

“…[1][2][3] Blokade saraf perifer yang dibutuhkan untuk memfasilitasi operasi ekstremitas bawah mencakup saraf femoral, saraf kutaneus femoral lateral, saraf obturator, dan saraf iskiadikus. [2][3][4] Blokade saraf iskiadikus digunakan untuk berbagai macam prosedur operasi di daerah ekstremitas bawah. Pada tindakan amputasi ekstremitas bawah, blokade saraf iskiadikus dapat mencegah phantom syndrome setelah pembedahan.…”

“…1,6 Terdapat beberapa teknik blokade saraf iskiadikus. 1,4,6 Teknik parasakral adalah satusatunya teknik blokade saraf ischiadikus yang dapat disebut sebagai a true plexus blockade. Hal ini disebabkan oleh blokade proksimal dari saraf iskiadikus yang mampu memblokade keseluruhan pleksus sakralis.…”