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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2004 September;70(9):625-9

language: English, Italian

Sciatic nerve block with lateral popliteal approach for hallux valgus correction. Comparison between 0.5% bupivacaine and 0.75% ropivacaine

Sinardi D. 1, Marino A. 1, Chillemi S. 1, Siliotti R. 2, Mondello E. 2

1 Anesthesiology and Intensive Care Department Istituto Ortopedico del Mezzogiorno d’Italia “F. Scalabrino”, Messina, Italy
2 Anesthesiological Section Department of Neurosciences Psychiatric and Anesthesiological Sciences University of Messina, Messina, Italy


Aim. In ­this ­study the ­authors com­pared the clin­i­cal pro­file of 2 ­local anesthet­ic ­drugs in the sciat­ic ­nerve ­block ­used dur­ing hal­lux val­gus cor­rec­tion, a sur­gi­cal pro­ce­dure ­known to be post­-op­er­a­tive­ly extreme­ly pain­ful. Since hal­lux val­gus cor­rec­tion is pain­ful post­-op­er­a­tive­ly, ­many ­attempts ­have ­been ­tried to ­ensure a ­long-last­ing anal­ge­sia. Block of the sciat­ic ­nerve ­appears to be the ­right ­choice bal­anc­ing ­ease to per­for­mance, sat­is­fac­tion of the ­patient and dura­tion of ­action.
Methods. The ­authors inves­ti­gat­ed the use of 20 ml of 0.5% bupiv­a­caine or 0.75% ropiv­a­caine regard­ing the ­speed of ­onset, qual­ity and ­length of dura­tion of sciat­ic ­nerve ­block per­formed ­with a lat­er­al pop­li­teal ­approach. Sixty ASA I-III ­patients (­aged 19-73 ­years) ­were ­enrolled in ­this ­trial. Written ­informed con­sent was ­asked and ­obtained. A 20 G 50 mm Teflon coat­ed Crawford nee­dle, deliv­er­ing 0.5 mA at 2 Hz, was ­used to ­locate and ­block the sciat­ic ­nerve in the pop­li­teal fos­sa ­with a lat­er­al ­approach. Results. Patients in the ropiv­a­caine ­group ­required ­about 13 min­utes to ­achieve a com­plete ­block and ­about 16 min­utes ­were need­ed in the bupiv­a­caine ­group for the anes­the­sia to be com­plete. The ­length of anal­ge­sia was 16 h for the ropiv­a­caine ­group and 13 h for the bupiv­a­caine ­group. This ­kind of ­approach to ­block the sciat­ic ­nerve ­appeared to the ­authors to be ­very ­easy to per­form, ­with the ­patient ­lying in a nat­u­ral posi­tion. Surgical anes­the­sia ­required ­less ­than 30 min in ­both ­groups to be ­ready, ­while the ropiv­a­caine ­group had a long­er ­length of anal­ge­sia com­pared to the bupiv­a­caine ­group.
Conclusions. Patient sat­is­fac­tion was ­high in ­both ­groups.

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