Spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery

Abstract

In lower extremity orthopedic surgeries, central and peripheral regional anesthesia techniques can be used along with general anesthesia, mainly in elderly patients with accompanying maladies. This study investigates the efficiency of spinal anesthesia and combined sciatic nerve/lumbar plexus block techniques in lower extremity orthopedic surgery in terms of patient-surgeon satisfaction. Fifty consecutive patients (age range: 50-90 years), with an ASA score of 2-3 were scheduled for lower extremity orthopedic surgery. The patients were randomly divided into two groups according to anesthesia type. Group 1 (25 patients) received spinal anesthesia (SA) and Group 2 (25 patients) a combined sciatic/lumbar plexus nerve block (CSLPB). Spinal anesthesia was performed with 3 ml of 0.75% ropivacaine, and the combined sciatic/lumbar plexus nerve block was obtained with 10 ml 0.75% of ropivacaine and 10 ml of normal saline (20 ml in total). We recorded the time elapsed during the administration of the anesthesia and the initiation of its effect. Evaluation was made on patient-surgeon satisfaction. Regional anesthesia duration was significantly longer in the CSLPB group (p<0.0001). The time required to prepare the patients for surgery was statistically and significantly shorter in the SA group (p<0.001). Values of patient and surgeon satisfaction did not significantly correlate (p>0.05). Both standard anesthesia and combined sciatic/lumbar plexus nerve block were effective in lower extremity orthopedic surgeries. Although surgery preparation time was longer in the CSLPB group, patient-surgeon satisfaction was similar in both groups.