Effects of the Intraneural and Subparaneural Ultrasound-Guided Popliteal Sciatic Nerve Block A Prospective, Randomized, Double-Blind Clinical and Electrophysiological Comparison

被引:27
|
作者
Cappelleri, Gianluca [1 ]
Cedrati, Valeria Libera Eva [1 ]
Fedele, Luisa Luciana [2 ]
Gemma, Marco [3 ]
Camici, Laura [2 ]
Loiero, Mario [1 ]
Gallazzi, Mauro Battista [1 ]
Cornaggia, Gabriele [1 ]
机构
[1] Ist Ortoped G Pini, Via Caduti Nassiriya 2, I-20068 Milan, Italy
[2] Univ Insubria Varese, Milan, Italy
[3] IRCCS San Raffaele, Milan, Italy
关键词
REGIONAL ANESTHESIA; LOCAL-ANESTHETICS; PARANEURAL SHEATH; ONSET TIME; INJECTION; INJURY; COMPLICATIONS; STIMULATION; BIFURCATION; PRESSURE;
D O I
10.1097/AAP.0000000000000413
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and Objectives: This prospective, randomized, double-blind study compared the effects of the ultrasound-guided popliteal sciatic nerve block performed by either intraneural or subparaneural approach followed by an electrophysiological evaluation. We hypothesized that intraneural injection provides a faster onset with a better success rate compared with the subparaneural approach. Methods: Eighty-eight patients were enrolled and randomized to receive an ultrasound-guided popliteal sciatic nerve block injecting 15 mL ropivacaine 1% according to an intraneural injection (group INTRA = 44) or a subparaneural injection (group SUBPARA = 44). The primary end point was the onset time of sensory and motor block, whereas secondary end points were successful, duration of the block, and the variation of the electrophysiological assessment after 5 weeks. The study was registered prior to patient enrollment (clinicaltrials. gov identifier NCT01987128). Results: The median onset time for successful sciatic nerve block in the INTRA group was 10 (5-15 [5-30]) minutes versus 25 (15-35 [5-45]) minutes in the SUBPARA group (P < 0.001), with a rate of 41/43 (95.3%) comparedwith 25/40 (62.5%) in the SUBPARA group (P < 0.001). No difference was found regardless of the duration of the block. Fifty-three patients also performed the electrophysiological assessment at 5 weeks, showing a subclinical, significant reduction in amplitude of the action potentials with no difference between groups. No patients reported any clinical neurological complications after 6 months. Conclusions: In ultrasound-guided popliteal sciatic nerve block, intraneural injection provided a faster onset and better success rate compared with subparaneural. Both techniques resulted in a similar subclinical reduction in amplitude of the sciatic action potentials at 5 weeks after surgery. These findings should not be extended to other approaches.
引用
收藏
页码:430 / 437
页数:8
相关论文
共 50 条
  • [1] Subparaneural Versus Circumferential Extraneural Injection at the Bifurcation Level in Ultrasound-Guided Popliteal Sciatic Nerve Blocks A Prospective, Randomized, Double-Blind Study
    Choquet, Olivier
    Noble, Guillaume Brault
    Abbal, Bertrand
    Morau, Didier
    Bringuier, Sophie
    Capdevila, Xavier
    REGIONAL ANESTHESIA AND PAIN MEDICINE, 2014, 39 (04) : 306 - 311
  • [2] Ultrasound-Guided Popliteal Block Distal to Sciatic Nerve Bifurcation Shortens Onset Time A Prospective Randomized Double-Blind Study
    Prasad, Arun
    Perlas, Anahi
    Ramlogan, Reva
    Brull, Richard
    Chan, Vincent
    REGIONAL ANESTHESIA AND PAIN MEDICINE, 2010, 35 (03) : 267 - 271
  • [3] Ultrasound-guided subparaneural popliteal sciatic nerve block: there is more to it than meets the eyes
    Karmakar, Manoj Kumar
    Reina, Miguel A.
    Sivakumar, Ranjith Kumar
    Areeruk, Pornpatra
    Pakpirom, Jatuporn
    Sala-Blanch, Xavier
    REGIONAL ANESTHESIA AND PAIN MEDICINE, 2021, 46 (03) : 268 - 275
  • [4] Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial
    Breebaart, Margaretha B.
    Branders, Jordi
    Sermeus, Luc
    Termurziev, Sultan
    Camerlynck, Helene
    Van Putte, Lennert
    Minelli, Marnik Van Putte
    De Hert, Stefan
    LOCAL AND REGIONAL ANESTHESIA, 2021, 14 : 43 - 50
  • [5] A Randomized Comparison Between Subepineural and Conventional Ultrasound-Guided Popliteal Sciatic Nerve Block
    Tran, De Q. H.
    Dugani, Shubada
    Pham, Kevin
    Finlayson, Roderick J.
    REGIONAL ANESTHESIA AND PAIN MEDICINE, 2011, 36 (06) : 548 - 552
  • [6] A Comparison of an Injection Cephalad or Caudad to the Division of the Sciatic Nerve for Ultrasound-Guided Popliteal Block: A Prospective Randomized Study
    Germain, Genevieve
    Levesque, Simon
    Dion, Nicolas
    Nadeau, Marie-Josee
    Cote, Dany
    Nicole, Pierre C.
    Turgeon, Alexis F.
    ANESTHESIA AND ANALGESIA, 2012, 114 (01): : 233 - 235
  • [7] Authors' Reply: Ultrasound-Guided Popliteal Sciatic Nerve Block
    Oguslu, Umut
    Gumus, Burcak
    Danisan, Guerkan
    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2023, 34 (11) : 2021 - 2021
  • [8] Intraneural Ultrasound-guided Sciatic Nerve Block Minimum Effective Volume and Electrophysiologic Effects
    Cappelleri, Gianluca
    Ambrosoli, Andrea Luigi
    Gemma, Marco
    Cedrati, Valeria Libera Eva
    Bizzarri, Federico
    Danelli, Giorgio Francesco
    ANESTHESIOLOGY, 2018, 129 (02) : 241 - 248
  • [9] Minimum effective local anesthetic volume for surgical anesthesia by subparaneural, ultrasound-guided popliteal sciatic nerve block: A prospective dose-finding study
    Bang, Seung Uk
    Kim, Dong Ju
    Bae, Jin Ho
    Chung, Kyudon
    Kim, Yeesuk
    MEDICINE, 2016, 95 (34)
  • [10] Ultrasound-Guided Popliteal Sciatic Nerve Block: Is It Time for a Bigger Stage?
    Discalzi, Andrea
    Nardelli, Floriana
    Calandri, Marco
    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2024, 35 (01) : 142 - 143