A comparison of lateral popliteal versus lateral midfemoral sciatic nerve blockade using ropivacaine 0.5%.
OBJECTIVE
The midfemoral approach to the sciatic nerve (MF) is a new technique that has been used for postoperative analgesia after knee surgery. The aim of the present study was to compare efficacy, performance time, and patient acceptance of the midfemoral approach to that of the lateral approach at the level of the popliteal fossa (popliteal block [PB]).


METHODS
Sixty-three patients were enrolled in this prospective, randomized study. Thirty-two patients received a lateral sciatic nerve block (group PB) and 31 patients a midfemoral block (group MF). Ropivacaine 0.5% (30 mL) was used in both groups.


RESULTS
The quality of nerve blockade was comparable in both groups. Onset of sensory block for peroneal and tibial nerves was significantly shorter in group MF than in group PB, 5 (1-20) minutes and 5 (1-20) minutes versus 10 (1-40) minutes and 10 (1-45) minutes, respectively. Onset of motor block in both territories was also shorter in group MF compared with PB, 6 (2-35) minutes and 5 (2-55) minutes versus 15 (2-60) minutes and 15 (2-60) minutes, respectively (P <.05). There was no difference in duration of sensory and motor blockade, 16 (7-32) hours versus 16 (6-43) hours and 16 (8-32) hours versus 16 (6-25) hours. There was no significant difference between both groups with respect to difficulty of nerve block performance. Patient discomfort during needle puncture was also similar.


CONCLUSIONS
The midfemoral approach to the sciatic nerve for ankle and foot surgery resulted in a reliable anesthetic, comparable to that of the lateral popliteal approach. This technique is simple, safe, and provides postoperative analgesia as effective as that obtained with the lateral approach.
Triadó
Vicente Domingo
VD
Department of Anesthesiology, Hospital Lluís Alcanyís de Xátiva, Valencia, Spain. vdt5677@mail.ono.es
Crespo
María T
MT
Aguilar
Jose L
JL
Atanassoff
Peter G
PG
Palanca
Jose M
JM
Moro
Blanca
B
D000328:Adult; D000368:Aged; D000577:Amides / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000187:drug effects; D009407:Nerve Block; D009475:Neurons, Afferent / Q000187:drug effects; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D000077212:Ropivacaine; D012584:Sciatic Nerve; D016683:Supine Position
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine