Combined femoral and sciatic nerve blocks for lower limb surgeries

Abstract

The peripheral nerve blocks can be used to interrupt the nerve pathways at multiple locations without undue sedation or loss of consciousness. Low incidence of pre and postoperative complications, good postoperative analgesia and increased operating room efficiency, all have accounted for the resurgence of interest in these techniques. The main aim of this study was to assess the suitability of this simple and safe technique for various unilateral lower limb surgeries and to assess the hemodynamic stability of the patients after this procedure.This prospective randomized study involved 50 patients, in the age group of 20-80 years, scheduled to undergo elective and emergency lower limb surgeries under combined femoral and sciatic nerve blocks. A sciatic nerve block was given by the posterior approach of Labat, and a femoral (3 in 1) block was given by Winnie's inguinal perivascular approach using a mixture of lidocaine, ropivicaine, and saline. Complete block was achieved in 92% of the patients. None of the patients had any complications and there was no significant difference between the pre-operative and post- operative vitals (pulse and blood pressure). 84% of the patients preferred to undergo the same anesthetic technique, if required in the future. Combined femoral(3-in-1) and sciatic nerve block is a simple, safe, and efficient technique with very low incidence of sideeffects and a negligible failure rate.