当前位置： SCI文献检索 > REGIONAL ANESTHESIA AND PAIN MEDICINE期刊下所有文献 > A Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.

A Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.

Abstract：

BACKGROUND AND OBJECTIVES:This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter entraps LA molecules, ensuring circumferential spread around the nerve. Therefore, in addition to comparable success rates, we also expected similar total anesthesia-related times (sum of performance and onset times) and designed this study as an equivalency trial. METHODS:Ultrasound-guided subparaneural posterior popliteal sciatic nerve block was carried out in 100 patients. In the SI group, LA was deposited at a single location between the tibial and peroneal nerves. In the TI group, LA was injected between the tibial and peroneal divisions, medial to the tibial nerve, and lateral to the common peroneal nerve. The total LA volume (15 mL) and mixture (lidocaine 1%-bupivacaine 0.25%-epinephrine 5 μg/mL) were identical in all subjects. The performance time, number of needle passes, and adverse events (paresthesia, neural edema) were recorded by the (nonblinded) investigator supervising the block. A blinded observer evaluated the success rate (sensorimotor composite score ≥6/8 points at 30 minutes) as well as the onset time and contacted patients 7 days after the surgery to inquire about persistent numbness or motor deficit. RESULTS:Both techniques provided comparable success rates (92%) and total anesthesia-related times (17.1-19.7 minutes). Expectedly, the SI group required fewer needle passes (1 vs 3; P < 0.001) and a shorter needling time (3.0 ± 2.3 minutes vs 4.0 ± 2.3 minutes; P = 0.025). The TI group displayed a shorter onset time (12.5 ± 7.9 minutes vs 15.8 ± 7.9 minutes; P = 0.027). The performance time, procedural discomfort, and incidence of paresthesia (14%-20%) were similar between the 2 groups. Sonographic neural swelling was detected in 2 subjects in the SI group. In both cases, the needle was carefully withdrawn and the injection was completed uneventfully. Follow-up of the 100 subjects 1 week after surgery revealed no residual numbness or motor deficit. CONCLUSIONS:Ultrasound-guided SI and TI subparaneural popliteal sciatic nerve blocks result in comparable success rates and total anesthesia-related times. Expectedly, the SI technique requires fewer needle passes.

journal_name

Reg Anesth Pain Med

journal_title

Regional anesthesia and pain medicine

authors

Tiyaprasertkul W,Bernucci F,González AP,Leurcharusmee P,Yazer MS,Techasuk W,Arnuntasupakul V,de la Garza DC,Finlayson RJ,Tran DQ

doi

10.1097/AAP.0000000000000253

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

315-20

issue

eissn

1098-7339

issn

1532-8651

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

在线工具

A Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.