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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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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. |
format | Online Article Text |
id | pubmed-4705568 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
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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