首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Sciatic nerve block in the popliteal fossa: description of a new medial approach: (Le bloc du nerf sciatique dans le creux poplite : une nouvelle approche mediale).
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Sciatic nerve block in the popliteal fossa: description of a new medial approach: (Le bloc du nerf sciatique dans le creux poplite : une nouvelle approche mediale).

机译:the窝中的坐骨神经阻滞:一种新的内侧方法的描述:(Le bloc du nerf sciatique dans le creux poplite:新手法内侧)。

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摘要

PURPOSE: Sciatic nerve blocks through lateral approaches in the popliteal fossa have been proposed. We describe a new medial approach to the sciatic nerve at this level. METHODS: After an anatomical study on six cadavers, we performed sciatic nerve blocks on 20 patients. A 100-mm insulated needle and a nerve stimulator were used; 20 mL of lidocaine 1.5% with epinephrine were injected. RESULTS: Patients lied in the supine position, the thigh flexed, abducted and rotated externally (30 degrees in all directions). The leg was flexed at 130 degrees . In this position, above the adductor tubercle, a depression known as Jobert's fossa is palpated. Through this groove, a medial approach to the sciatic nerve at the level of the popliteal fossa is possible. The mean distance between the adductor tubercle and the puncture site is 6.18 cm (range 4-8 cm) and the mean distance between the skin and the sciatic nerve is 6.62 cm (range 4-9 cm). Mean time to perform the block was 100 sec (range 55-165 sec). Complete motor blockade was obtained after a mean time of 30 min (range 5-60 min) inside the common peroneal nerve area and 43 min (range 15-75 min) inside the tibial nerve area. Motor block was complete in 17 patients and sensory block in 18 patients. No vessel puncture was observed. CONCLUSION: We describe a new medial approach to the sciatic nerve in the popliteal fossa. More studies will be required to demonstrate the technique is effective and safe.
机译:目的:提出了通过lateral窝外侧入路的坐骨神经阻滞。我们在这个水平上描述了一种针对坐骨神经的新的内侧入路。方法:对6具尸体进行解剖学研究后,我们对20例患者进行了坐骨神经阻滞。使用100毫米绝缘针和神经刺激器。注射20 mL 1.5%的利多卡因和肾上腺素。结果:患者躺在仰卧位,大腿弯曲,外展并向外旋转(所有方向均为30度)。腿弯曲了130度。在这个位置,在内ad结节上方,触诊称为Jobert窝的凹陷处。通过该凹槽,可以在the窝水平处接近坐骨神经。内收结节与穿刺点之间的平均距离为6.18厘米(4-8厘米),皮肤与坐骨神经之间的平均距离为6.62厘米(4-9厘米)。执行该块的平均时间为100秒(范围为55-165秒)。在腓总神经区域内平均30分钟(5-60分钟范围内)和胫神经区域内43分钟(15-75分钟范围内)的平均时间后,获得了完全的运动阻滞。 17例患者完成运动阻滞,18例患者感觉阻滞。没有观察到血管穿刺。结论:我们描述了一种新的内侧方法,用于media窝的坐骨神经。将需要更多的研究来证明该技术是有效和安全的。

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