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Comparative Evaluation of Nerve Stimulation and Ultrasound Guidance for Popliteal Block: A Randomized Double Blinded Study

Iswaryarajan Hercule, Assistant Professor, Department of Anaesthesiology, Sri Venkateshwaraa Medical College and Hospital, Ariyur, Pondicherry 605102, India. , Radhakrishnan A.1 , Iswaryarajan Hercule2

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Indian Journal of Anesthesia and Analgesia 5(2):p 168-172, February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.3

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Abstract

Introduction: Popliteal block is one of the rarely performed regional anaesthetic techniques because it requires great expertise in anatomical land marks and is often very technically challenging. Recent introduction of ultrasound technique for nerve blocks has gained popularity when comparing to the standard nerve stimulation technique. In this study, we have compared the success rate, duration of block procedureand complications between nerve stimulation and ultra sound guidance of popliteal block. Methods: 120 patients undergoing foot and ankle surgery were randomized to receive the block using either the nerve stimulation (n = 60) or the ultra sound technique (n = 60). Ropivacaine 0.25% (30 mL)was injected for both the groups. Results: Duration of the block procedure and block failure rate were significantly higher in nerve stimulation technique than the ultra sound technique (P value < 0.05). There were no differences in onset and duration of block between two techniques. The nerve stimulation guidance was associated with significant incidence of vascular puncture (13.3%) but ultrasound technique was safer with nil incidence of vascular puncture. Conclusions: Ultrasound guidance technique was better in lesser block procedure time and a good success rate (P value < 0.05) and was safer, with no incidence of vascular puncture.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.3

Keywords

Nerve Stimulation; Popliteal Block; Ropivacaine; Ultra Sound.

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