Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe.

[Sciatic nerve block "out-of-plane" distal to the bifurcation: effective and safe]. Anaesthesist. 2017 Jan 24;: Authors: Geiser T, Apel J, Vicent O, Büttner J Abstract BACKGROUND: Ultrasound guided distal sciatic nerve block (DSB) at bifurcation level shows fast onset and provides excellent success rates. However, its safe performance might be difficult for the unexperienced physician. Just slightly distal to the bifurcation, the tibial nerve (TN) and common fibular nerve (CFN) can be shown clearly separated from each other. Therefore, we investigated if a block done here would provide similar quality results compared to the DSB proximally to the division, with a potentially lower risk of nerve damage. METHODS: In this randomized, prospective trial, 56 patients per group received either a DSB distal to the bifurcation "out-of-plane" (dist.) or proximally "in-plane" (prox.) with 30 ml of Mepivacaine 1% each. Success was tested by a blinded examiner after 15 and 30 min respectively (sensory and motor block of TN and CFN: 0 = none, 2 = complete, change of skin temperature). Videos of the blocks were inspected by an independent expert retrospectively with regard to the spread of the local anesthetic (LA) and accidental intraneural injection. RESULTS: Cumulative single nerve measurements and temperature changes revealed significant shorter onset and better effic...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
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