Comparison of Time Development of the Sciatic Nerve Blockade Performed with 1% Lidocaine Subgluteal and Popliteal Approach under Ultrasound Guidance

DOI: 10.4236/ojanes.2014.412046   PDF   HTML   XML   2,839 Downloads   3,369 Views  

Abstract

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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Valery, P. , Aliaksei, M. , Andrei, B. and Kokhan, Z. (2014) Comparison of Time Development of the Sciatic Nerve Blockade Performed with 1% Lidocaine Subgluteal and Popliteal Approach under Ultrasound Guidance. Open Journal of Anesthesiology, 4, 324-331. doi: 10.4236/ojanes.2014.412046.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Marhofer, P., Harrop-Griffiths, W., et al. (2010) Fifteen Years of Ultrasound Guidance in Regional Anaesthesia: Part 1. British Journal of Anaesthesia, 104, 538-546.
http://dx.doi.org/10.1093/bja/aeq069
[2] Marhofer, P., Greher, M. and Kapral, S. (2005) Ultrasound Guidance in Regional Anaesthesia. British Journal of Anaesthesia, 94, 7-17.
http://dx.doi.org/10.1093/bja/aei002
[3] Piacherski, V., Marochkov, A., Brukhnou, A. and Kokhan, Z. (2012) Comparison of Three Methods of Regional Anesthesia of Peripheral Nerves and Plexuses. Open Journal of Anesthesiology, 2, 237-243.
http://dx.doi.org/10.4236/ojanes.2012.25056
[4] Moayeri, N. and Groen, G.J. (2009) Differences in Quantitative Architecture of Sciatic Nerve May Explain Differences in Potential Vulnerability to Nerve Injury, Onset Time, and Minimum Effective Anesthetic Volume. Anesthesiology, 111, 1128-1134.
http://dx.doi.org/10.1097/ALN.0b013e3181bbc72a
[5] Kilpatrick, A.W., Coventry, D.M. and Todd, J.G. (1992) A Comparison of Two Approaches to Sciatic Nerve Block. Anaesthesia, 47, 155-157.
http://dx.doi.org/10.1111/j.1365-2044.1992.tb02018.x
[6] Taboada, M., Rodriguez, J., Del Rio, S., Lagunilla, J., Carceller, J., Alvarez, J. and Atanassoff, P.G. (2005) Does the Site of Injection Distal to the Greater Trochanter Make a Difference in Lateral Sciatic Nerve Blockade? Anesthesia & Analgesia, 101, 1188-1191.
http://dx.doi.org/10.1213/01.ane.0000172289.83180.2e
[7] Taboada, M., Alvarez, J., Cortes, J., Rodriguez, J., Rabanal, S., Gude, F., Atanassoff, A. and Atanassoff, P.G. (2004) The Effects of Three Different Approaches on the Onset Time of Sciatic Nerve Blocks with 0.75% Ropivacaine. Anesthesia & Analgesia, 98, 242-247.
http://dx.doi.org/10.1213/01.ANE.0000093311.29111.59
[8] Perlas, A., Brull, R., Chan, V.W., McCartney, C.J., Nuica, A. and Abbas, S. (2008) Ultrasound Guidance Improves the Success of Sciatic Nerve Block at the Popliteal Fossa. Regional Anesthesia and Pain Medicine, 33, 259-265.
http://dx.doi.org/10.1016/j.rapm.2007.10.010
[9] Bruhn, J., Van Geffen, G.J., Gielen, M.J. and Scheffer, G.J. (2008) The Value of Ultrasonography for Performing Peripheral Nerve Blocks. Acta Anaesthesiologica Scandinavica, 52, 1298-1302.
http://dx.doi.org/10.1111/j.1399-6576.2008.01695.x
[10] Brull, R., Macfarlane, A.J., Parrington, S.J., Koshkin, A. and Chan, V.W. (2011) Is Circumferential Injection Advantageous for Ultrasound-Guided Popliteal Sciatic Nerve Block? A Proof-of-Concept Study. Regional Anesthesia & Pain Medicine, 36, 266-270.
http://dx.doi.org/10.1097/AAP.0b013e318217a6a1
[11] Piacherski, V. and Marachkou, A. (2014) Features and Principles the Spread of Local Anesthetic Blockade of the Sciatic Nerve at Depends on the Amount of Anesthetic. Open Journal of Anesthesiology, 4, 31-35.
http://dx.doi.org/10.4236/ojanes.2014.42004
[12] Andersen, H.L., Andersen, S.L. and Tranum-Jensen, J. (2012) Injection inside the Paraneural Sheath of the Sciatic Nerve: Direct Comparison among Ultrasound Imaging, Macroscopic Anatomy, and Histologic Analysis. Regional Anesthesia and Pain Medicine, 37, 410-414.
http://dx.doi.org/10.1097/AAP.0b013e31825145f3
[13] Perlas, A., Wong, P., Abdallah, F., Hazrati, L.N., Tse, C. and Chan, V. (2013) Ultrasound-Guided Popliteal Block through a Common Paraneural Sheath versus Conventional Injection: A Prospective, Randomized, Double-Blind Study. Regional Anesthesia and Pain Medicine, 38, 218-225.
http://dx.doi.org/10.1097/AAP.0b013e31828db12f
[14] Vloka, J.D., Hadzic, A., Lesser, J.B., Kitain, E., Geatz, H., April, E.W. and Thys, D.M. (1997) A Common Epineural Sheath for the Nerves in the Popliteal Fossa and Its Possible Implications for Sciatic Nerve Block. Anesthesia & Analgesia, 84, 387-390.
[15] Karmakar, M.K., Shariat, A.N., Pangthipampai, P. and Chen, J. (2013) High-Definition Ultrasound Imaging Defines the Paraneural Sheath and the Fascial Compartments Surrounding the Sciatic Nerve at the Popliteal Fossa. Regional Anesthesia and Pain Medicine, 38, 447-451.
http://dx.doi.org/10.1097/AAP.0b013e31829ffcb4
[16] Cuvillon, P., Nouvellon, E., Ripart, J., Boyer, J.C., Dehour, L., Mahamat, A., L’hermite, J., Boisson, C., Vialles, N., Lefrant, J.Y. and de La Coussaye, J.E. (2009) A Comparison of the Pharmacodynamics and Pharmacokinetics of Bupivacaine, Ropivacaine (with Epinephrine) and Their Equal Volume Mixtures with Lidocaine Used for Femoral and Sciatic Nerve Blocks: A Double-Blind Randomized Study. Anesthesia & Analgesia, 108, 641-649.
http://dx.doi.org/10.1213/ane.0b013e31819237f8
[17] Moayeri, N., Bigeleisen, P.E. and Groen, G.J. (2008) Quantitative Architecture of the Brachial Plexus and Surrounding Compartments, and Their Possible Significance for Plexus Blocks. Anesthesiology, 108, 299-304.
http://dx.doi.org/10.1097/01.anes.0000299433.25179.70
[18] Riazi, S., Carmichael, N., Awad, I., Holtby, R.M. and McCartney, C.J. (2008) Effect of Local Anaesthetic Volume (20 vs 5 ml) on the Efficacy and Respiratory Consequences of Ultrasound-Guided Interscalene Brachial Plexus Block. British Journal of Anaesthesia, 101, 549-556.
http://dx.doi.org/10.1093/bja/aen229
[19] Valery, P. and Aliaksei, M. (2013) A Comparison of the Onset Time of Complete Blockade of the Sciatic Nerve in the Application of Ropivacaine and Its Equal Volumes Mixture with Lidocaine: A Double-Blind Randomized Study. Korean Journal of Anesthesiology, 65, 42-47.
http://dx.doi.org/10.4097/kjae.2013.65.1.42
[20] Robards, C., Hadzic, A., Somasundaram, L., Iwata, T., Gadsden, J., Xu, D. and Sala-Blanch, X. (2009) Intraneural Injection with Low-Current Stimulation during Popliteal Sciatic Nerve Block. Anesthesia & Analgesia, 109, 673-637.
http://dx.doi.org/10.1213/ane.0b013e3181aa2d73
[21] Taboada, M., Rodríguez, J., álvarez, J., Cortés, J., Gude, F. and Atanassoff, P.G. (2004) Sciatic Nerve Block via Posterior Labat Approach Is More Efficient Than Lateral Popliteal Approach Using a Double-Injection Technique: A Prospective, Randomized Comparison. Anesthesiology, 101, 138-142.
http://dx.doi.org/10.1097/00000542-200407000-00022
[22] Seidel, R., Natge, U. and Schulz, J. (2013) Distal Sciatic Nerve Blocks: Randomized Comparison of Nerve Stimulation and Ultrasound Guided Intraepineural Block. Der Anaesthesist, 62, 183-192.
http://dx.doi.org/10.1007/s00101-013-2150-5
[23] Gautier, P., Vandepitte, C., Ramquet, C., DeCoopman, M., Xu, D. and Hadzic, A. (2011) The Minimum Effective Anesthetic Volume of 0.75% Ropivacaine in Ultrasound-Guided Interscalene Brachial Plexus Block. Anesthesia & Analgesia, 113, 951-955.
[24] González, A.P., Bernucci, F., Techasuk, W., Pham, K., Finlayson, R.J. and De Tran, Q.H. (2013) A Randomized Comparison between 3 Combinations of Volume and Concentration of Lidocaine for Ultrasound-Guided Infraclavicular Block. Regional Anesthesia and Pain Medicine, 38, 206-211.
[25] Bouaziz, H., Iohom1, G., Estèbe, J.P., Campana, W.M. and Myers, R.R. (2005) Effects of Levobupivacaine and Ropivacaine on Rat Sciatic Nerve Blood Flow. British Journal of Anaesthesia, 95, 696-700.
http://dx.doi.org/10.1093/bja/aei242

  
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