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MINERVA ANESTESIOLOGICA

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 2017 Oct 12

DOI: 10.23736/S0375-9393.17.12061-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Two different placement paths in popliteal fossa with a novel nerve block needle with external indwelling cannula for postoperative analgesia after foot and ankle surgery: a randomized controlled trial

Miao HE, Dandan LING, Guang-Yu CAI, Tian-Xiao ZOU, Bin YU

Department of Anesthesiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China


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BACKGROUND: Previous studies have documented that single injection nearby the sciatic nerve bifurcation would influence the anesthesia and analgesia effect. But this is uncertain for preoperative continuous popliteal sciatic nerve block. So we conducted this trial to compare two paths (proximal to the bifurcation and at the bifurcation) of ultrasound guided continuous popliteal sciatic nerve block in foot and ankle surgery.
METHODS: 40 recruited objects were randomly assigned to receive ultrasound-guided continuous popliteal sciatic nerve block at the puncture path proximal to the nerve bifurcation either at the nerve bifurcation. Subjects received an injection using a novel nerve block needle with external indwelling cannula guided by ultrasound invented by the corresponding author. The external indwelling cannula was inserted for postoperative analgesia. The primary outcome was NRS scores (at rest and during movement) times at 24h after surgery. The secondary outcomes included the measurements related to the performance of the nerve block and efficacy of analgesia, such as anesthesia effect grade, grade of nausea and vomiting, case number of patients with cannula leaking, occlusion or slipping, patient satisfaction, etc.
RESULTS: During the surgery, 6 subjects in the proximal group needed additional analgesic, significantly different from 1 in the at bifurcation group (P<0.05). There was significant difference on anesthesia effect rating, 1.6±0.8 in the proximal group and 1.1 ±0.4 in another (P<0.05). The proximal group got 2.1±1.6 of NRS on rest at 24th and 1.7±1.5 at 48th, and the at bifurcation group got 0.9±1.4 at 24th and 0.7±1.1 at 48th (P<0.05). The proximal group got more PCA times during 6th-24th and 24th-48th and lower satisfaction scores.
CONCLUSIONS: Continuous popliteal sciatic nerve block at nerve bifurcation could receive better analgesia effect and more patients’ satisfaction, rather than proximal to the bifurcation.


KEY WORDS: Continuous popliteal sciatic nerve block - Postoperative analgesia - Foot and ankle surgery - Ultrasound guidance

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Publication History

Article first published online: October 12, 2017
Manuscript accepted: October 10, 2017
Manuscript revised: September 6, 2017
Manuscript received: March 12, 2017

Cite this article as

He M, Ling D, Cai GY, Zou TX, Yu B. Two different placement paths in popliteal fossa with a novel nerve block needle with external indwelling cannula for postoperative analgesia after foot and ankle surgery: a randomized controlled trial. Minerva Anestesiol 2017 Oct 12. DOI: 10.23736/S0375-9393.17.12061-4

Corresponding author e-mail

yubintongji0@163.com