Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injecting proximal to the bifurcation.
BACKGROUND: We hypothesized that blocking the tibial and common peroneal nerves individually using ultrasound distal to sciatic bifurcation would decrease time to complete block compared with a block proximal to the bifurcation. METHODS: Seventy-six patients undergoing foot or ankle surgery received a sciatic nerve block either proximal or distal to the point of bifurcation. A mixture of 28 mL 1.5% mepivacaine with 100 microg clonidine and 1 mL 8.4% sodium bicarbonate for a total of 30 mL was used. Ultrasound was used to guide needle adjustments to achieve circumferential spread. Block success was defined as a loss of sensation to pinprick in both nerve distributions within 46 minutes. RESULTS: Patients in the tibial-peroneal group had significantly faster time to complete block than the sciatic group (19.2 vs 26.1 minutes; P = 0.006). CONCLUSIONS: Blocking the tibial and common peroneal nerves in the popliteal fossa separately provides for a faster onset than a prebifurcation sciatic block.
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机译：背景：我们假设，使用坐骨神经叉分叉远端的超声分别阻断胫骨和腓总神经，与分支叉近端的阻断相比，可减少完成阻断的时间。方法：76名接受足部或踝部手术的患者在分叉点的近端或远端接受了坐骨神经阻滞。使用28 mL 1.5％哌维卡因与100 microg可乐定和1 mL 8.4％碳酸氢钠的混合物，总共30 mL。超声用于引导针调整以实现周向扩展。阻滞成功的定义是在46分钟内两种神经分布的针刺感丧失。结果：胫骨-腓骨组的患者完成阻塞的时间明显快于坐骨神经痛组（19.2 vs 26.1分钟; P = 0.006）。结论：分别阻塞the窝的胫神经和腓总神经比起分叉前的坐骨神经阻滞，起效更快。
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