Comparison between ultrasound-guided sciatic–femoral nerve block and unilateral spinal anesthesia in below-knee amputation surgery

Abstract

Objectives To compare unilateral spinal anesthesia and ultrasound-guided combined sciatic–femoral nerve block (SFB) regarding hemodynamic stability, quality of nerve block, bladder function, and time-to-readiness for discharge (TRD) in below-knee amputation surgery. Patients and methods A total of 80 patients who underwent knee amputation surgery (40 per group) were enrolled in the study. They were randomly assigned to one of two groups. Group A received 2 ml (10 mg) of 0.5% levobupivacaine, and group B (SFB) received 25 ml contains 10 ml of 2.0% lidocaine, 10 ml of 0.5% levobupivacaine, and 5 ml of saline (15 ml of femoral and 10 ml of sciatic nerve block). Surgical anesthesia time, time of operation, total time of anesthesia, time-to-first spontaneous urination, time-to-first analgesia, TRD, and patient satisfaction were recorded. Results Onset of sensory and motor blocks was significantly shorter in group A compared with group B, whereas the recovery time for sensory and motor blocks was longer in group B compared with group A. In the group A, time-to-first analgesia was significantly shorter than the SFB group B; time-to-first spontaneous urination and TRD in the group A were significantly longer than the SFB group B. Pain score was highly significant lower in group B compared with group A after surgery. Conclusion SFB provided sufficient sensory blockage, duration, patient satisfaction, and postoperative analgesia than the unilateral spinal anesthesia.