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A Comparison of Injection of 0.375% Ropivacaine before and after the Bifurcation of Sciatic Nerve for Ultrasound Guided Popliteal Block

G. Anand Isaac, Assistant Professor, Dept. of Aneasthesiology, Narayana Medical College, Nellore, Andhra Pradesh 524003, India. , Jayanth M.N.1 , G. Anand Isaac2 , Penchalaiah3 , Krishna Chaithanya4 , Narsimha Reddy5 , Bhoopal Naik6

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Indian Journal of Anesthesia and Analgesia 5(5):p 736-740, May 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5518.7

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Abstract

 

Introduction: Lower limb surgeries were performed under popliteal block. Over the years Sciatic nerve has been blocked pre bifurcation by using peripheral nerve stimulator and blind techniques. But thanks to the Ultrasound which allowed us to visualize the branches of Sciatic nerve post bifurcation like tibial and common peroneal nerves in the popliteal fossa. 

Aims and Objectives: To compare onset of action of sensory and motor blockade between pre birfurcation sciatic nerve block with post bifurcation common peroneal nerve and tibial nerve block. 

Materials and Methods: This prospective randomized observational double blind study was conducted in 102 ASA I and II patients scheduled for surgeries on ankle and foot who were randomized into two groups A and B. Group A received 20ml 0.375% ropivacaine for tibial nerve and 10ml of 0.375% for common peroneal nerve post bifurcation whereas in Group B 30 ml of 0.375% ropivacaine was given pre bifurcation. Grade of Sensory and motor blockade were assessed every 5 minutes till complete surgical blockade and Block onset time were measured. 

Results: The Mean Onset of Block in group A was 18.5±4.1 min whereas in group B was 21.5 ±2.7 min (p <0.0001) which was statistically significant. Rate of complete sensory and motor block was also faster in group A compared to group B. 

Conclusion: Sciatic nerve block post bifurcation provides rapid onset of block and faster complete sensory and motor block compared to blocking the sciatic nerve before bifurcation.



 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5518.7

Keywords

Sciatic Nerve Block; Tibial Nerve; Common Peroneal Nerve; Ropivacaine.

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