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Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults

BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at...

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Autores principales: Lollo, Loreto, Bhananker, Sanjay, Stogicza, Agnes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705568/
https://www.ncbi.nlm.nih.gov/pubmed/26807391
http://dx.doi.org/10.4103/2229-5151.170846
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author Lollo, Loreto
Bhananker, Sanjay
Stogicza, Agnes
author_facet Lollo, Loreto
Bhananker, Sanjay
Stogicza, Agnes
author_sort Lollo, Loreto
collection PubMed
description BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at risk of severe opioid induced side effects. Patient and operative technical factors can preclude use of preoperative regional anesthesia. The purpose of this study was to assess complications following sciatic popliteal and femoral or saphenous nerve blockade administered to anesthetized adult patients following foot and ankle surgery. MATERIALS AND METHODS: Postoperative patients administered general anesthesia received popliteal sciatic nerve blockade and either femoral or saphenous nerve blockade if operative procedures included medial incisions. Nerve blocks were placed with nerve stimulator or ultrasound guidance. A continuous nerve catheter was inserted if hospital admission was over 24 hours. Opioid analgesic supplementation was administered for inadequate pain relief. Postoperative pain scores and total analgesic requirements for 24 hours were recorded. Nerve block related complications were monitored for during the hospital admission and at follow up surgical clinic evaluation. RESULTS: 190 anesthetized adult patients were administered 357 nerve blocks. No major nerve injury or deficit was reported. One patient had numbness in the toes not ascribed to a specific nerve of the lower extremity. Perioperative opioid dose differences were noted between male and female and between opioid naïve and tolerant patients.
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spelling pubmed-47055682016-01-22 Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults Lollo, Loreto Bhananker, Sanjay Stogicza, Agnes Int J Crit Illn Inj Sci Original Article BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at risk of severe opioid induced side effects. Patient and operative technical factors can preclude use of preoperative regional anesthesia. The purpose of this study was to assess complications following sciatic popliteal and femoral or saphenous nerve blockade administered to anesthetized adult patients following foot and ankle surgery. MATERIALS AND METHODS: Postoperative patients administered general anesthesia received popliteal sciatic nerve blockade and either femoral or saphenous nerve blockade if operative procedures included medial incisions. Nerve blocks were placed with nerve stimulator or ultrasound guidance. A continuous nerve catheter was inserted if hospital admission was over 24 hours. Opioid analgesic supplementation was administered for inadequate pain relief. Postoperative pain scores and total analgesic requirements for 24 hours were recorded. Nerve block related complications were monitored for during the hospital admission and at follow up surgical clinic evaluation. RESULTS: 190 anesthetized adult patients were administered 357 nerve blocks. No major nerve injury or deficit was reported. One patient had numbness in the toes not ascribed to a specific nerve of the lower extremity. Perioperative opioid dose differences were noted between male and female and between opioid naïve and tolerant patients. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4705568/ /pubmed/26807391 http://dx.doi.org/10.4103/2229-5151.170846 Text en Copyright: © International Journal of Critical Illness and Injury Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Lollo, Loreto
Bhananker, Sanjay
Stogicza, Agnes
Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title_full Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title_fullStr Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title_full_unstemmed Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title_short Postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
title_sort postoperative sciatic and femoral or saphenous nerve blockade for lower extremity surgery in anesthetized adults
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705568/
https://www.ncbi.nlm.nih.gov/pubmed/26807391
http://dx.doi.org/10.4103/2229-5151.170846
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