A Comparison of Continuous Sciatic Nerve Block and Patient Controlled Analgesia with Morphin for Postoperative Analgesia in Children Undergoing Major Foot Surgery

Saricaoglu, Fatma; Ayhan, Banu; Aycan, İlker Öngüç; Dal, Didem; Akıncı, Seda Banu; Aksoy, Cemalettin; Aypar, Ülkü

doi:10.5336/medsci.2009-15014

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…Once quadriceps muscle contraction associated with femoral nerve stimulation and "patellar twitch" were observed, and when "patellar twitch" was seen to persist when the current was reduced to 0.5 mA, 30 ml 0.5% ropivacaine was administered gradually with the negative aspiration test. Subsequently, in order to perform the Meier technique, the iliaca anterior superior, pubic tubercle and trochanter major were indicated without changing the patient's position [4,5]. The line joining the pubic tubercle and the iliaca anterior superior was regarded as the inguinal ligament.…”

Section: Case Reportsmentioning

confidence: 99%

“…When quadriceps muscle contraction associated with stimulation of the femoral nerve and "patellar twitch" were observed, and once "patellar twitch" persisted when the current was lowered to 0.5 mA, 25 ml 0.5% was gradually administered with the negative aspiration test. For lateral femoral cutaneous block, we entered an average of 1-1.5 cm inferior to the spina iliaca anterior superior and 1-1.5 cm from the medial aspect, and 10 ml 0.5% ropivacaine was given following description of paresthesia [3,4]. Subsequently, in order to perform anterior sciatic nerve block using Meier's method, the spina iliaca anterior superior, pubic tubercle and trochanter major were marked without changing the patient's position [4,5].…”

Section: Case Reportsmentioning

confidence: 99%

“…For lateral femoral cutaneous block, we entered an average of 1-1.5 cm inferior to the spina iliaca anterior superior and 1-1.5 cm from the medial aspect, and 10 ml 0.5% ropivacaine was given following description of paresthesia [3,4]. Subsequently, in order to perform anterior sciatic nerve block using Meier's method, the spina iliaca anterior superior, pubic tubercle and trochanter major were marked without changing the patient's position [4,5]. The line joining the pubic tubercle and iliaca anterior superior was taken as the ligamentum inguinale.…”

Section: Case Reportsmentioning

confidence: 99%

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Peripheral nerve block to the lower extremity despite relative contraindication (two cases)

Koşucu¹,

Beşir²,

Eroğlu³

2013

J Anesthesiol Clin Sci

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Peripheral nerve blocks can provide a number of advantages in high-risk patients and may sometimes be preferred despite relative contraindication. Our first case had relative contraindication due to being confused, with a Glasgow coma score of 10, and our second case due to the presence of bacteremia, and also the anti-platelet treatment he was receiving. In this case report we describe our experience with peripheral nerve block to the lower extremity in two high-risk patients with relative contraindication. Block with the classic Winnie approach (3-1) and anterior sciatic nerve block with the Meier method were applied in both cases, with lateral femoral cutaneous block being additionally performed in the second case. No complications were observed.

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Section: Case Reportsmentioning

confidence: 99%

Section: Case Reportsmentioning

confidence: 99%

Section: Case Reportsmentioning

confidence: 99%

See 1 more Smart Citation

Peripheral nerve block to the lower extremity despite relative contraindication (two cases)

Koşucu¹,

Beşir²,

Eroğlu³

2013

J Anesthesiol Clin Sci

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“…No analgesic variation was found if 5 or 8 ml/hour of 0.2% ropivacaine was used for a continuous popliteal SNB in patients having hallux valgus surgery 29 . Saricaoglu et al 30 demonstrated that continuous SNB can successfully be used in children for postoperative analgesia after foot surgery: compared with morphine PCA, continuous popliteal SNB reduced patients' morphine requirements, PONV, pruritus and urinary retention.…”

Section: Ankle and Foot Surgerymentioning

confidence: 99%

The Role of Regional Anaesthesia Techniques in the Management of Acute Pain

Cowlishaw

Scott

Barrington

2012

Anaesth Intensive Care

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Regional anaesthesia and analgesia techniques are used to effectively manage acute pain after a variety of surgeries. With the rapid growth of ultrasound-guided procedures, anaesthetists are re-examining regional anaesthesia and analgesia and their roles in pain management. In this evolving field previous published data may not reflect current practice. Therefore, a narrative review of recent literature was undertaken to establish the current utility and efficacy of regional anaesthesia and analgesia for the management of acute pain following surgery. Only prospective randomised controlled trials published between March 2009 and March 2011 with outcome measures of analgesia efficacy were included. Sixty-five randomised controlled trials were identified involving 4841 patients. Regional techniques for the management of knee (26%), abdominal (26%) and shoulder (14%) surgery were most frequently studied. The review provides further evidence that regional anaesthesia and analgesia can offer excellent analgesia with acceptable side-effects for the management of post surgical pain. In addition, the results of this review support the use of ultrasound guidance when performing regional techniques and continuous catheter techniques to prolong analgesia.

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“…17,18 We wondered about the alkalinization effect on "infusion" and "infusion+bolus" methods in continuous femoral catheter. We observed that "infusion+ bolus" methods in the block with alkalinization and non-alkalinization groups caused a prolonged sensorimotor block duration.…”

Section: Figurementioning

confidence: 99%

The Effects of Alkalinization of 0.5% Ropivacaine by Adding Sodium Bicarbonate on Block Onset, Ending Time and Quality, and Postoperative Analgesic Efficiency for Peripheral Nerve Block in Unilateral Extremity Surgery

Koşucu¹,

Ulusoy²,

Erciyes³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate block onset/ending times and quality, and the postoperative analgesic efficiency of ropivacaine compared with ropivacaine alkalinized by the adding sodium bicarbonate solution for femoral, anterior sciatic and lateral femoral cutaneous block. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : ASA1-2 48 patients undergoing lower extremity surgery were randomized into one of two groups: combined femoral, anterior sciatic and lateral femoral cutaneous block with 0.5% ropivacaine, or the same blocks with 0.5% ropivacaine+8.4% sodium bicarbonate in a ratio of 1:20. Postoperative analgesia was achieved by femoral catheter using 0.2% ropivacaine, in all patients. Groups R (non-alkalinized) and RB (alkalinized) were both further subdivided into "infusion" (10 ml.hour) and "infusion+bolus" (5 mL bolus+5 mL/hour) groups. Block onset/ending times, pain scores and amounts of local anesthetic consumed were evaluated. R Re es su ul lt ts s: : Sensorimotor "onset times" were shortened and "ending times" were prolonged in the alkalinized group. Motor and the majority of dermatome sensorial block ending times were prolonged in the alkalinized "infusion+bolus" group, although the amount of local anesthetic consumed was lower. C Co on nc cl lu us si io on n: : The alkalinization of 0.5% ropivacaine with 8.4% sodium bicarbonate in a 1:20 ratio used in peripheral nerve block may provide a shorter onset block time. The application of "infusion+bolus" via femoral catheter may lead to prolonged block time and reduce the consumption of local anesthetic, especially in the alkalinized group. K Ke ey y W Wo or rd ds s: : Peripheral nerves; nerve block; sodium bicarbonate; lower extremity Ö ÖZ ZE ET T A Am ma aç ç: : Ropivakaine bikarbonat eklenmesiyle oluşan alkalinizasyonun femoral, anterior siyatik, lateral femoral kutanöz blok başlangıç/sonlanış zamanlarına, blok kalitesine, postoperatif analjeziye etkilerini değerlendirmek. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Alt ekstremite cerrahisi geçirecek ASA 1-2 48 hasta randomize olarak iki gruba ayrıldı. Her iki gruba femoral, anterior siyatik, lateral femoral kutanöz blok kombinasyonu yapıldı, bir grupta %0,5 ropivakain, diğer grupta ropivakaine ilave olarak %8,4'lük sodyum bikarbonat 1/20 oranında kullanıldı. Tüm hastalarda postoperatif analjezi femoral kateter aracılığıyla %0,2 ropivakainle sağlandı, ancak Group R (non-alkalinize) ve Grup RB (alkalinize), kendi içlerinde "infüzyon"(10 mL/saat) ve "infüzyon+bolus"(5 mL bolus+5 mL/saat) olarak tekrar ikiye ayrıldı. Blok başlangıç/sonlanış zamanları, lokal anestezik tüketim miktarları karşılaştırıldı. B Bu ul lg gu ul la ar r: : Alkalinize grupta sensorimotor blok başlangıç zamanı kısalmış, sonlanış zamanı uzamıştı. Motor ve çoğu dermatomda sensorial blok sonlanış zamanı alkalinize "infüzyon+bolus" grubunda lokal anestezik tüketimi daha düşük olmasına rağmen uzamıştı. S So on nu uç ç: : %0,5'lik ropivakainin %8,4'lük sodyum bikarbonatla alkalinizasyon...

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A Comparison of Continuous Sciatic Nerve Block and Patient Controlled Analgesia with Morphin for Postoperative Analgesia in Children Undergoing Major Foot Surgery

Cited by 4 publications

References 9 publications

Peripheral nerve block to the lower extremity despite relative contraindication (two cases)

Peripheral nerve block to the lower extremity despite relative contraindication (two cases)

The Role of Regional Anaesthesia Techniques in the Management of Acute Pain

The Effects of Alkalinization of 0.5% Ropivacaine by Adding Sodium Bicarbonate on Block Onset, Ending Time and Quality, and Postoperative Analgesic Efficiency for Peripheral Nerve Block in Unilateral Extremity Surgery

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