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Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study

BACKGROUND: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. MATERIALS AND MET...

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Autores principales: Albokrinov, Andrew A., Fesenko, Ulbolhan A., Huz, Taras B., Perova-Sharonova, Valentyna M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682050/
https://www.ncbi.nlm.nih.gov/pubmed/29213283
http://dx.doi.org/10.1155/2017/9454807
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author Albokrinov, Andrew A.
Fesenko, Ulbolhan A.
Huz, Taras B.
Perova-Sharonova, Valentyna M.
author_facet Albokrinov, Andrew A.
Fesenko, Ulbolhan A.
Huz, Taras B.
Perova-Sharonova, Valentyna M.
author_sort Albokrinov, Andrew A.
collection PubMed
description BACKGROUND: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. MATERIALS AND METHODS: Neurostimulator-guided SNB and FNB from the lateral supratrochanteric approach were performed. Local anesthetic spread in SNB and FNB after radiographic opacification was analyzed. Time and number of attempts to perform blocks, needle depth, and clinical efficacy were assessed. RESULTS: Mean needle passes number and procedure time for SNB were 2.5 ± 0.3 and 2.4 ± 0.2 min, respectively. Mean needle passes number and procedure time for FNB were 2.7 ± 0.27 and 2.59 ± 0.23 min, respectively. Mean skin to nerve distance was 9.1 ± 0.45 cm for SNB and 8.8 ± 0.5 cm for FNB. Radiographic opacification of SNB showed local anesthetic spread close to the sacrum and involvement of sacral plexus nerve roots. Spread of local anesthetic in FNB was typical. Intraoperative fentanyl administration was required in 2 patients (9.5%) with mean dose 1.8 ± 0.2 mcg/kg. Mean postoperative pain score was 0.34 ± 0.08 of 10. CONCLUSION: The lateral supratrochanteric approach to SNB and FNB in children can be an effective lower limb analgesic technique in supine patients. The trial is registered with ISRCTN70969666.
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spelling pubmed-56820502017-12-06 Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study Albokrinov, Andrew A. Fesenko, Ulbolhan A. Huz, Taras B. Perova-Sharonova, Valentyna M. Anesthesiol Res Pract Clinical Study BACKGROUND: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. MATERIALS AND METHODS: Neurostimulator-guided SNB and FNB from the lateral supratrochanteric approach were performed. Local anesthetic spread in SNB and FNB after radiographic opacification was analyzed. Time and number of attempts to perform blocks, needle depth, and clinical efficacy were assessed. RESULTS: Mean needle passes number and procedure time for SNB were 2.5 ± 0.3 and 2.4 ± 0.2 min, respectively. Mean needle passes number and procedure time for FNB were 2.7 ± 0.27 and 2.59 ± 0.23 min, respectively. Mean skin to nerve distance was 9.1 ± 0.45 cm for SNB and 8.8 ± 0.5 cm for FNB. Radiographic opacification of SNB showed local anesthetic spread close to the sacrum and involvement of sacral plexus nerve roots. Spread of local anesthetic in FNB was typical. Intraoperative fentanyl administration was required in 2 patients (9.5%) with mean dose 1.8 ± 0.2 mcg/kg. Mean postoperative pain score was 0.34 ± 0.08 of 10. CONCLUSION: The lateral supratrochanteric approach to SNB and FNB in children can be an effective lower limb analgesic technique in supine patients. The trial is registered with ISRCTN70969666. Hindawi 2017 2017-10-29 /pmc/articles/PMC5682050/ /pubmed/29213283 http://dx.doi.org/10.1155/2017/9454807 Text en Copyright © 2017 Andrew A. Albokrinov et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Albokrinov, Andrew A.
Fesenko, Ulbolhan A.
Huz, Taras B.
Perova-Sharonova, Valentyna M.
Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title_full Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title_fullStr Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title_full_unstemmed Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title_short Lateral Supratrochanteric Approach to Sciatic and Femoral Nerve Blocks in Children: A Feasibility Study
title_sort lateral supratrochanteric approach to sciatic and femoral nerve blocks in children: a feasibility study
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682050/
https://www.ncbi.nlm.nih.gov/pubmed/29213283
http://dx.doi.org/10.1155/2017/9454807
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