Ultrasound vs nerve stimulation multiple injection technique for posterior popliteal sciatic nerve block

Anaesthesia. 2009 Jun;64(6):638-42. doi: 10.1111/j.1365-2044.2009.05915.x.

Abstract

In this prospective, randomised, observer-blinded study we evaluated whether ultrasound guidance can shorten the onset time of popliteal sciatic nerve block as compared to nerve stimulation with a multiple injection technique. Forty-four ASA I-III patients undergoing posterior popliteal sciatic nerve block with 20 ml of 0.75% ropivacaine were randomly allocated to nerve stimulation or ultrasound guided nerve block. A blinded observer recorded onset of sensory and motor blocks, success rates, the need for fentanyl intra-operatively, the requirement for general anaesthesia, procedure-related pain, patient satisfaction and side-effects. Onset times for sensory and motor blocks were comparable. The success rate was 100% for ultrasound guided vs 82% for nerve stimulation (p = 0.116). Ultrasound guidance reduced needle redirections (p = 0.01), were associated with less procedural pain (p = 0.002) and required less time to perform (p = 0.002). Ultrasound guidance reduced the time needed for block performance and procedural pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Amides / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Drug Administration Schedule
  • Electric Stimulation / methods
  • Female
  • Foot / surgery
  • Humans
  • Male
  • Middle Aged
  • Movement / drug effects
  • Nerve Block / adverse effects
  • Nerve Block / methods*
  • Patient Satisfaction
  • Prospective Studies
  • Ropivacaine
  • Sciatic Nerve / diagnostic imaging*
  • Sensation / drug effects
  • Single-Blind Method
  • Time Factors
  • Ultrasonography, Interventional / methods*

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine