Document Detail


Distal Tourniquet or Leg Position After Injection Enhances the Efficacy of Sciatic Nerve Blockade by the Popliteal Approach.
MedLine Citation:
PMID:  21965360     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:In this study, we hypothesized that leg positioning and distal tourniquet application, when compared with neutral positioning of the leg, alters the efficacy of sciatic nerve block performed by the double-stimulation technique.Methods:Ninety randomized, consecutive, ASA physical status I to III patients undergoing foot and ankle surgery with a popliteal fossa block (using a double-stimulation technique with the patient in prone position) were prospectively studied. Patients were randomized to have the blocked leg either kept in a neutral position immediately after the patient was turned supine (group 1), flexed 45 degrees at the thigh and maintained in that position for 15 minutes (group 2), or have a distal tourniquet applied with the leg in a neutral position and inflated during injection of the local anesthetic with the patient supine (group 3). A standardized local anesthetic mixture containing 15 mL of 2% prilocaine and 15 mL of 0.5% levobupivacaine was used in all study groups.Results:The onset times for sensory and motor blocks were shorter, and the time to recovery of blocks was longer, postprocedure in both group 2 and 3.Conclusions:Similar beneficial effects might be reached with the application of a distal tourniquet during injection or elevating the patient's leg turned supine immediately after sciatic nerve block with a popliteal approach by a double-injection technique. We suggest that using the leg-up position or application of a distal tourniquet for sciatic nerve block may lead to a more proximal distribution of the local anesthetic and may result in a faster onset of sensory and motor blocks as well as longer duration of blockade.
Authors:
Nezih Sertoz; M Nuri Deniz; H Omer Ayanoglu
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-29
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  -     ISSN:  1526-7598     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.
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