Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs

2021 ◽  
Vol 82 (6) ◽  
pp. 449-458
Author(s):  
Vincent Marolf ◽  
Keila K. Ida ◽  
Danuta Siluk ◽  
Wiktoria Struck-Lewicka ◽  
Michał J. Markuszewski ◽  
...  
Keyword(s):  
Intravenous Administration ◽  
Saphenous Nerve ◽  
Nerve Blocks

scholarly journals Nerve Blocks around the Knee in Children

1984 ◽  
Vol 12 (1) ◽  
pp. 14-17 ◽  
Author(s):  
P. M. Kempthorne ◽  
T. C. K. Brown
Keyword(s):  
Tibial Nerve ◽  
Common Peroneal Nerve ◽  
Saphenous Nerve ◽  
Popliteal Fossa ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Peripheral Nerve Stimulator ◽  
Below The Knee ◽  
The Common ◽  
Equinus Deformity

Analgesia below the knee can be achieved by blocking the tibial nerve and the common peroneal nerve in the popliteal fossa, and the saphenous nerve adjacent to the knee. The anatomy and technique of nerve block in the popliteal fossa is described, the nerve being located prior to blockade using a peripheral nerve stimulator. The block as described has been used in children for postoperative analgesia, as a diagnostic block, and as an adjunct to the physiotherapy management of severe equinus deformity after brain injury.

scholarly journals Does Dexmedetomidine Have a Perineural Mechanism of Action When Used as an Adjuvant to Ropivacaine?

2017 ◽  
Vol 126 (1) ◽  
pp. 66-73 ◽  
Author(s):  
Jakob H. Andersen ◽  
Ulrik Grevstad ◽  
Hanna Siegel ◽  
Jørgen B. Dahl ◽  
Ole Mathiesen ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Outcome Measure ◽  
Detection Threshold ◽  
Saphenous Nerve ◽  
Heat Pain ◽  
Nerve Blocks ◽  
Heat Stimulation ◽  
Temperature Sensation ◽  
Peripheral Mechanism ◽  
Pain Detection

Abstract Background Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. Methods The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0.5% plus 1 ml saline in the other thigh. The primary outcome measure was the duration of block assessed by temperature sensation (alcohol swab). The secondary outcome measure was the duration of block assessed by pinprick, pain during tonic heat stimulation, warmth detection threshold, and heat pain detection threshold. Results All 21 enrolled volunteers completed the trial. The mean duration of block assessed by temperature sensation in the leg receiving ropivacaine plus dexmedetomidine was 22 h (95% CI, 21 to 24) compared to 20 h (95% CI, 19 to 21) in the leg receiving ropivacaine plus placebo with a mean difference of 2 h (95% CI, 1 to 3; P = 0.001). The duration of block was also significantly longer in the leg receiving dexmedetomidine when assessed by pinprick, pain during tonic heat stimulation, and warmth detection threshold but not heat pain detection threshold. One participant experienced numbness in an area in the leg receiving dexmedetomidine. Conclusions Dexmedetomidine prolongs the duration of a saphenous nerve block by a peripheral mechanism when controlling for systemic effects but not necessarily to a clinically relevant extent.

scholarly journals Ideal Anatomic Location for Saphenous Nerve Block for Foot and Ankle Surgeries: A Prospective Randomized Clinical Evaluation

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Karl Henrikson ◽  
Sanjib Adhikary ◽  
Gregory Pace ◽  
Wai Liu ◽  
Paul Juliano ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Score ◽  
Nerve Block ◽  
Knee Extension ◽  
Saphenous Nerve ◽  
Foot And Ankle ◽  
Nerve Blocks ◽  
Knee Extension Strength ◽  
Significant Difference ◽  
Isometric Knee Extension

Category: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.

Ultrasound guidance for the performance of sciatic and saphenous nerve blocks in dogs

2011 ◽  
Vol 187 (2) ◽  
pp. 221-224 ◽  
Author(s):  
Cristina Costa-Farré ◽  
Xavier Sala Blanch ◽  
J. Ignacio Cruz ◽  
Jordi Franch
Keyword(s):  
Ultrasound Guidance ◽  
Saphenous Nerve ◽  
Nerve Blocks

scholarly journals Perineural dexamethasone with subsartorial saphenous nerve blocks in ACL reconstruction

2016 ◽  
Vol 25 (4) ◽  
pp. 1298-1306 ◽  
Author(s):  
Mary F. Chisholm ◽  
Jennifer Cheng ◽  
Kara G. Fields ◽  
Robert G. Marx ◽  
Daniel B. Maalouf ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Saphenous Nerve ◽  
Nerve Blocks

Individual Nerve Blocks of the Lumbar Plexus

2020 ◽  
pp. 127-141
Keyword(s):  
Lower Extremity ◽  
Nerve Block ◽  
Obturator Nerve ◽  
Saphenous Nerve ◽  
Cutaneous Nerve ◽  
Nerve Blocks ◽  
Adductor Canal ◽  
Obturator Nerve Block ◽  
Femoral Cutaneous Nerve ◽  
Fascia Iliaca Block

This chapter describes individual nerve blocks of the lower extremity to include the fascia iliaca block, lateral femoral cutaneous nerve block, obturator nerve block, saphenous nerve block, and the adductor canal approach to the saphenous nerve block.

Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

2017 ◽  
Vol 39 (3) ◽  
pp. 332-337 ◽  
Author(s):  
Kathleen Jarrell ◽  
Elizabeth McDonald ◽  
Rachel Shakked ◽  
Kristen Nicholson ◽  
Vincent Kasper ◽  
...  
Keyword(s):  
Nerve Block ◽  
Continuous Flow ◽  
Single Injection ◽  
Outpatient Setting ◽  
Saphenous Nerve ◽  
Foot And Ankle ◽  
Opioid Use ◽  
Nerve Blocks ◽  
Catheter Group ◽  
Ankle Surgery

Background: The increasing scope and complexity of foot and ankle procedures performed in an outpatient setting require more intensive perioperative analgesia. Regional anesthesia (popliteal and saphenous nerve blocks) has been proven to provide satisfactory pain management, decreased postoperative opioid use, and earlier patient discharge. This can be further augmented with the placement of a continuous-flow catheter, typically inserted into the popliteal nerve region. This study investigated the use of a combined popliteal and saphenous continuous-flow catheter nerve block compared to a single popliteal catheter and single-injection saphenous nerve block in postoperative pain management after ambulatory foot and ankle surgery. Methods: A prospective study was conducted using 60 patients who underwent foot and ankle surgery performed in an outpatient setting. Demographic data, degree of medial operative involvement, American Society of Anesthesiologists physical classification system, anesthesia time, and postanesthesia care unit time were recorded. Outcome measures included pain satisfaction, numeric pain scores (NPS) at rest and with activity, and opioid intake. Patients were also classified by degree of saphenous nerve involvement in the operative procedure, by the surgeon who was blinded to the anesthesia randomization. Results: Patients in the dual-catheter group took significantly less opioid medication on the day of surgery and postoperative day 1 (POD 1) compared to the single-catheter group ( P = .02). The dual-catheter group reported significantly greater satisfaction with pain at POD 1 and POD 3 and a significantly lower NPS at POD 1, 2, and 3. This trend was observed in all 3 subgroups of medial operative involvement. Conclusion: Patients in the single-catheter group reported more pain, less satisfaction with pain control, and increased opioid use on POD 1, suggesting dual-catheter use was superior to single-injection nerve blocks with regard to managing early postoperative pain in outpatient foot and ankle surgery. Level of Evidence: Level II, prospective cohort study.

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