scholarly journals Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery

2011 ◽  
Vol 45 ◽  
pp. 225-232 ◽  
Author(s):  
Suzan Adali
Keyword(s):  
Sciatic Nerve ◽  
Lower Extremity ◽  
Spinal Anesthesia ◽  
Orthopedic Surgery ◽  
Lumbar Plexus ◽  
Lumbar Plexus Block ◽  
Plexus Block

scholarly journals Sciatic Nerve and Lumbar Plexus Block for Below Knee Amputation- Newer Approach for Better Haemodynamic Stability and Patient Safety

2021 ◽  
Author(s):  
Jigisha Bharatbhai Mehta ◽  
Ganesh Naik ◽  
Dinesh Chauhan
Keyword(s):  
Patient Safety ◽  
Sciatic Nerve ◽  
Regional Blood Flow ◽  
Present Report ◽  
Lumbar Plexus ◽  
Nerve Blocks ◽  
Knee Amputation ◽  
Haemodynamic Stability ◽  
Lumbar Plexus Block ◽  
Plexus Block

Patients undergoing lower extremity amputation may have multiple co-morbid conditions like diabetes, cardiovascular, hepatic and renal disorders and are at risk of perioperative mortality and morbidity. Peripheral nerve blocks are associated with minimal haemodynamic changes, improved regional blood flow and are ideal for high risk patients who cannot tolerate slightest attenuation in haemodynamic response. The present report is of a 50-year-old female patient admitted for below knee amputation surgery. Sciatic nerve and lumbar plexus block were the mode of anaesthesia. It was found that regional anaesthesia in the form of nerve block provided adequate anaesthesia and analgesia, provided greater haemodynamic stability and patient safety.

scholarly journals The Comparing of Ultrasound-guided Techniques: Sciatic Block with Continuous Lumbar Plexus Block or Continuous Femoral Nerve Block for Anesthesia and Analgesia of Total knee Replacement

2013 ◽  
Vol 7 (1) ◽  
pp. 19-25
Author(s):  
M. Dauri ◽  
S. Faria ◽  
L. Celidonio ◽  
P. David ◽  
A. Bianco ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lumbar Plexus ◽  
Ultrasound Guided ◽  
Lumbar Plexus Block ◽  
Total Knee ◽  
Plexus Block

Background and Aims: This double blind prospective randomized clinical trial evaluated the efficacy and safety of continuous ultrasound-guided lumbar plexus block compared to continuous ultrasound-guided femoral nerve block, in the intra-operative and postoperative periods after total knee replacement. Methods: Forty ASA I-III patients were randomized to receive: continuous femoral block (n= 20, 30 ml of ropivacaine 5 mg/ml) or continuous lumbar plexus block (n= 20, 30 ml of ropivacaine 5 mg/ml) both in association with single injection sciatic nerve block. All patients received continuous infusion of 2 mg/ml of ropivacaine at 8 ml/h for 48 hours and intravenous morphine for patient-controlled analgesia. Primary outcomes were intra-operative sufentanil consumption and verbal analogue scale (VAS) score at rest at 24h follow up. Results: Intra-operative sufentanil consumption was higher in the femoral block (FEM) group compared to the lumbar plexus block (PSOAS) group (FEM: 10.00 (10.00, 17.50) µg; PSOAS: 2.50 (0.00, 10.00) µg. p= 0.002). Obturator motor blockade occurred more frequently in the PSOAS group (70%) than in the FEM group (40%) (p=0.1); however, we found no differences in sensory blockade (p=0.6). VAS at rest was similar in the two groups at 24h postoperatively (FEM: 29.50 ± 14.74 mm; PSOAS: 25.60 ±17.42 mm. p=0.4), and throughout the follow-up period. No differences were detected in pain scores during physiotherapy. Conclusion: Continuous femoral and lumbar plexus blocks, both in association with sciatic nerve block, provided similar VAS scores at 24h, and throughout the follow-up period; intra-operative sufentanil consumption was, however, lower in the lumbar plexus block group.

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