Abstract
BackgroundThe widespread of hallux valgus surgery in a day care setting enhanced the role of regional anaesthesia in the last few years. Sciatic nerve block at popliteal fossa has been shown to provide safe and effective analgesia. Our purpose was to compare the success rate and performance time of popliteal block during resident’s training for regional anaesthesia by using nerve stimulation (NS) or combined nerve stimulation and ultrasound (NS + US).Methods70 adult patients undergoing hallux valgus surgery were randomly assigned to receive sciatic nerve block at popliteal fossa with US+NS or NS alone with a double injection technique for peroneal and tibial branches, respectively. Two residents experienced with nerve stimulator performed the procedures after a learning phase concerning ultrasonography. A local anaesthetic solution, containing 10 mL of 0.75% ropivacaine and 10 mL of 2% lidocaine was used: 12 mL were infiltrated close the tibial nerve, and 8mL were infiltrated close the common peroneal nerve. Block success rate, sensory block onset time, block performance time were evaluated. Recourse to general anaesthesia was considered as failure.ResultsNo differences were detected in success rate and onset time of sensory block between the two groups (P > 0.05). The time to block tibial nerve and the overall block time were significantly faster in US+NS group (P < 0.05).ConclusionsUltrasound guidance for popliteal nerve block resulted in similar success rate with a faster procedure time when compared with nerve stimulator, thus providing a possible effect on resident education and operating room efficiency.
Highlights
The widespread of hallux valgus surgery in a day care setting enhanced the role of regional anaesthesia in the last few years
Among the different peripheral nerve block techniques used for forefoot surgery, sciatic nerve block at popliteal fossa provides safe and effective analgesia reducing the doses of local anaesthetic, opioids and minimizing the risk of complications [1]
In nerve stimulation (NS) + US group direct visualization of tibial nerve was possible in all cases but common peroneal nerve was directly visualized in 31 patients
Summary
The widespread of hallux valgus surgery in a day care setting enhanced the role of regional anaesthesia in the last few years. The widespread of hallux valgus surgery in a day care setting enhanced the role of regional anesthesia in the last few years. Among the different peripheral nerve block techniques used for forefoot surgery, sciatic nerve block at popliteal fossa provides safe and effective analgesia reducing the doses of local anaesthetic, opioids and minimizing the risk of complications [1]. The aim of this study was to compare the success rate and performance time of popliteal block during training for regional anaesthesia by using nerve stimulation (NS) or combined nerve stimulation and ultrasound
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