[Combined transgluteal ischial and femoral nerve block: retrospective data on 65 risk patients with leg amputation].
For amputations of the lower limbs the combined blockade of the sciatic nerve (via the transgluteal approach) and the femoral nerve (via the inguinal route) may be a suitable alternative to general or neuroaxial anaesthetic methods. In highly comorbid, high risk patients this catheter-linked regional anaesthesia combines the advantages of avoiding controlled ventilation with decreased cardiovascular depression, as conveyed by the use of general anaesthesia or neuraxial techniques. Furthermore, improved postoperative analgesia may be achieved for several days. In our retrospective study, 65 patients who were scheduled for amputation of the lower limbs were analysed. In 58 patients (89%), a regional anaesthesia technique employing only a catheter technique was performed and only 7 patients (11%) required additional general anaesthesia. For postoperative pain management, local anaesthetics were administered via an indwelling nerve block catheter and excellent pain scores were achieved in these patients. However, successful employment of this technique necessitates sufficiently trained personnel as well as on-going training in the performance of catheter-based local analgesia.
Raith
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Abteilung für Anästhesie und Intensivmedizin, LKH Graz-West, Göstingerstrasse 22, 8020 Graz, Osterreich. christian.raith@lkh-grazwest.at
Kölblinger
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Walch
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local / Q000627:therapeutic use; D002404:Catheterization; D004558:Electric Stimulation; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007649:Ketamine; D007866:Leg / Q000601:surgery*; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy; D010880:Piperidines; D000077208:Remifentanil; D012189:Retrospective Studies; D018570:Risk Assessment
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D010880:Piperidines; D007649:Ketamine; D000077208:Remifentanil; D008874:Midazolam