Ultrasound vs nerve stimulation multiple injection technique for posterior popliteal sciatic nerve block.
In this prospective, randomised, observer-blinded study we evaluated whether ultrasound guidance can shorten the onset time of popliteal sciatic nerve block as compared to nerve stimulation with a multiple injection technique. Forty-four ASA I-III patients undergoing posterior popliteal sciatic nerve block with 20 ml of 0.75% ropivacaine were randomly allocated to nerve stimulation or ultrasound guided nerve block. A blinded observer recorded onset of sensory and motor blocks, success rates, the need for fentanyl intra-operatively, the requirement for general anaesthesia, procedure-related pain, patient satisfaction and side-effects. Onset times for sensory and motor blocks were comparable. The success rate was 100% for ultrasound guided vs 82% for nerve stimulation (p = 0.116). Ultrasound guidance reduced needle redirections (p = 0.01), were associated with less procedural pain (p = 0.002) and required less time to perform (p = 0.002). Ultrasound guidance reduced the time needed for block performance and procedural pain.
Danelli
G
G
Department of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital, Parma, Italy.
Fanelli
A
A
Ghisi
D
D
Moschini
E
E
Rossi
M
M
Ortu
A
A
Baciarello
M
M
Fanelli
G
G
D000328:Adult; D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D005528:Foot / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D000077212:Ropivacaine; D012584:Sciatic Nerve / Q000000981:diagnostic imaging*; D012677:Sensation / Q000187:drug effects; D016037:Single-Blind Method; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine