[Combined sciatic and inguinal paravascular nerve block: a valid alternative for arthroscopic knee surgery].
OBJECTIVE
To assess the effectiveness of a combined transgluteal sciatic and inguinal paravascular nerve block for arthroscopic knee surgery.


METHODS
Prospective descriptive study of 88 patients scheduled for arthroscopic knee surgery. Using a nerve stimulator and a transgluteal approach, we infiltrated the sciatic nerve with 20 mL of 1.5% mepivacaine. Then, with the patient in supine position, we located the femoral nerve and inserted a plastic catheter into the descending inguinal canal, applying pressure near the tip, to inject 20 mL of 1% mepivacaine. We evaluated a) anesthetic effectiveness, b) tolerance of the pressure cuff, c) time in the intensive care recovery unit, and d) time until reversal of the block.


RESULTS
Anesthesia was efficacious for 89.77% of the patients: excellent for 54 patients (61.36%), good for 25 (28.41%), and insufficient for 9 (10.23%). The pressure cuff was well tolerated by 70 patients (79.54%) and caused discomfort for 18 (20.45%). Mean postoperative stay in the intensive care recovery unit was 19.05 (SD 8.11) minutes. Reversal took place at a mean 204.09 (SD 22.59) minutes for the sensory nerve block and at 223.45 (SD 20) minutes for the motor block.


CONCLUSIONS
The combined sciatic and inguinal paravascular block is effective for arthroscopic knee surgery and offers an alternative when other anesthetic techniques cannot be used. Use of a pressure cuff may require complementary sedation.
Monzó
E
E
Servicio de Anestesiología y Reanimación, Centro de Traumatología y Rehabilitación FREMAP, Majadahonda, Madrid. enrique_monzo@fremap.es
Hajro
M
M
Galindo
F
F
Baeza
C
C
González
A
A
García
M
M
Barreiro
A
A
D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D007717:Knee / Q000601:surgery*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D012584:Sciatic Nerve