Which Ultrasound-Guided Sciatic Nerve Block Strategy Works Faster? Prebifurcation or Separate Tibial-Peroneal Nerve Block? A Randomized Clinical Trial

Overview

Journal Anesth Pain Med

Publisher Brieflands

Date 2018 Apr 12

PMID 29637044

Citations 2

Authors

Seyed Hamid Reza Faiz

Farnad Imani

Poupak Rahimzadeh

Mahmoud Reza Alebouyeh

Saeed Reza Entezary

Amineh Shafeinia

Affiliations

Soon will be listed here.

Abstract

Background: Peripheral nerve block is an accepted method in lower limb surgeries regarding its convenience and good tolerance by the patients. Quick performance and fast sensory and motor block are highly demanded in this method. The aim of the present study was to compare 2 different methods of sciatic and tibial-peroneal nerve block in lower limb surgeries in terms of block onset.

Methods: In this clinical trial, 52 candidates for elective lower limb surgery were randomly divided into 2 groups: sciatic nerve block before bifurcation (SG; n = 27) and separate tibial-peroneal nerve block (TPG; n = 25) under ultrasound plus nerve stimulator guidance. The mean duration of block performance, as well as complete sensory and motor block, was recorded and compared between the groups.

Results: The mean duration of complete sensory block in the SG and TPG groups was 35.4 ± 4.1 and 24.9 ± 4.2 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). The mean duration of complete motor block in the SG and TPG groups was 63.3 ± 4.4 and 48.4 ± 4.6 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). No nerve injuries, paresthesia, or other possible side effects were reported in patients.

Conclusions: According to the present study, it seems that TPG shows a faster sensory and motor block than SG.

Citing Articles

Artificial intelligence technology and ultrasound-guided nerve block for analgesia in total knee arthroplasty.

Tong S, Li R, Wang D, Xie X, Ruan Y, Huang L World J Clin Cases. 2023; 11(29):7026-7033.

PMID: 37946775 PMC: 10631398. DOI: 10.12998/wjcc.v11.i29.7026.

Quantitative assessment of ultrasound-guided sciatic nerve block - A comparison of a single-point versus two-point injection technique: A randomised controlled, double-blinded trial.

Nag K, Ravishankar M, Parthasarathy S, Thomas T Indian J Anaesth. 2023; 67(9):802-808.

PMID: 37829774 PMC: 10566652. DOI: 10.4103/ija.ija_140_23.

References

Tiyaprasertkul W, Bernucci F, Gonzalez A, Leurcharusmee P, Yazer M, Techasuk W . A Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block. Reg Anesth Pain Med. 2015; 40(4):315-20. DOI: 10.1097/AAP.0000000000000253. View

Choquet O, Morau D, Biboulet P, Capdevila X . Where should the tip of the needle be located in ultrasound-guided peripheral nerve blocks?. Curr Opin Anaesthesiol. 2012; 25(5):596-602. DOI: 10.1097/ACO.0b013e328356bb40. View

Provenzano D, Viscusi E, Adams Jr S, Kerner M, Torjman M, Abidi N . Safety and efficacy of the popliteal fossa nerve block when utilized for foot and ankle surgery. Foot Ankle Int. 2002; 23(5):394-9. DOI: 10.1177/107110070202300504. View

Eldegwy M, Ibrahim S, Hanora S, Elkarta E, Elsily A . ULTRASOUND-GUIDED SCIATIC POLITEAL NERVE BLOCK: A COMPARISON OF SEPARATE TIBIAL AND COMMON PERONEAL NERVE INJECTIONS VERSUS INJECTING PROXIMAL TO THE BIFURCATION. Middle East J Anaesthesiol. 2015; 23(2):171-6. View

Rahimzadeh P, Faiz S . Ultrasound a new paradigm in regional anesthesia and pain management. Anesth Pain Med. 2013; 3(2):228-9. PMC: 3833046. DOI: 10.5812/aapm.13363. View

Buys M, Arndt C, Vagh F, Hoard A, Gerstein N . Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injecting proximal to the bifurcation. Anesth Analg. 2009; 110(2):635-7. DOI: 10.1213/ANE.0b013e3181c88f27. View

Sala-Blanch X, de Riva N, Carrera A, Lopez A, Prats A, Hadzic A . Ultrasound-guided popliteal sciatic block with a single injection at the sciatic division results in faster block onset than the classical nerve stimulator technique. Anesth Analg. 2012; 114(5):1121-7. DOI: 10.1213/ANE.0b013e318248e1b3. View

Gorsewski G, Dinse-Lambracht A, Tugtekin I, Gauss A . [Ultrasound-guided peripheral regional anesthesia : placement and dosage of local anesthetics]. Anaesthesist. 2012; 61(8):711-21. DOI: 10.1007/s00101-012-2045-x. View

Yamamoto H, Sakura S, Wada M, Shido A . A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block. Anesth Analg. 2014; 119(6):1442-8. DOI: 10.1213/ANE.0000000000000462. View

10.

Safari S, Rahimzadeh P, Haghighi M . Local infiltration anesthesia: does it really work?. Ann Transl Med. 2015; 3(18):275. PMC: 4630558. DOI: 10.3978/j.issn.2305-5839.2015.09.24. View

11.

Germain G, Levesque S, Dion N, Nadeau M, Cote D, Nicole P . Brief reports: a comparison of an injection cephalad or caudad to the division of the sciatic nerve for ultrasound-guided popliteal block: a prospective randomized study. Anesth Analg. 2011; 114(1):233-5. DOI: 10.1213/ANE.0b013e3182373887. View

12.

Paqueron X, Bouaziz H, Macalou D, Labaille T, Merle M, Laxenaire M . The lateral approach to the sciatic nerve at the popliteal fossa: one or two injections?. Anesth Analg. 1999; 89(5):1221-5. View

13.

Arcioni R, Palmisani S, Della Rocca M, Romano S, Mercieri M, De Blasi R . Lateral popliteal sciatic nerve block: a single injection targeting the tibial branch of the sciatic nerve is as effective as a double-injection technique. Acta Anaesthesiol Scand. 2006; 51(1):115-21. DOI: 10.1111/j.1399-6576.2006.01164.x. View

14.

Tran D, Dugani S, Pham K, Al-Shaafi A, Finlayson R . A randomized comparison between subepineural and conventional ultrasound-guided popliteal sciatic nerve block. Reg Anesth Pain Med. 2011; 36(6):548-52. DOI: 10.1097/AAP.0b013e318235f566. View

15.

Prasad A, Perlas A, Ramlogan R, Brull R, Chan V . Ultrasound-guided popliteal block distal to sciatic nerve bifurcation shortens onset time: a prospective randomized double-blind study. Reg Anesth Pain Med. 2010; 35(3):267-71. DOI: 10.1097/AAP.0b013e3181df2527. View