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

Hussien, Ayman; Elhalim, Mohamed Abd Elgawad Abd; Zarad, Mohamed Shehata

doi:10.4103/sjamf.sjamf_6_20

Cited by 1 publication

(2 citation statements)

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“…Satisfaction of patients was significantly higher in group B compared to group A. 28 Regarding sciatic dosing, the choice of local anesthetic and dose administered is dependent on the type of surgery. For example, for knee arthroplasty, a low concentration of 20 ml ropivacaine (0.16%) is all that is required to block the sciatic nerve for 12 to 16 h. On the other hand, for relieving the pain of amputation surgery, choice of local anesthetic does not matter as sensorymotor separation is not an issue.…”

Section: Shamim Et Al (2018)mentioning

confidence: 91%

“…One reason for this was the lack of ultrasound, which has transformed the current regional anesthesia practice. 28 conducted a study 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. A total of 80 patients who underwent knee amputation surgery were enrolled in the study.…”

Section: Shamim Et Al (2018)mentioning

confidence: 99%

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The incidence of post amputation syndrome after pericapsular nerve group block versus sciatico-femoral nerve block in patients undergoing above knee amputation

Hussein Bakeer,

Hussien Hussien,

El Shaikh

et al. 2023

Anaesth. pain intensive care

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Background & objective: Regional anesthesia for orthopedic procedures has been widely practiced around the globe, and it has been employed either alone or in combination with general anesthesia. An above knee amputation will need blockade of both femoral and sciatic nerves for successful pain control and help with peripheral sensitization for the patient. Pericapsular nerve group (PENG) block is a novel regional nerve block to provide analgesia in fractured hip patients. We assessed the effectiveness of this block compared to sciatico-femoral block and the incidence of post amputation syndrome in patients undergoing above knee amputation. Methodology: This randomized controlled single-blinded study was carried out on 30 patients with lower limb bone tumors indicated for above knee amputation admitted to surgery clinic, National Cancer Institute, Cairo University. The duration of study was from January 2021 to May 2022. Patients were randomized equally using opaque sealed envelopes into 2 groups Group A: (n = 15) pericapsular nerve group block group (PNGB) to receive 20 mL of 0.125% bupivacaine with 4 mg dexamethasone at the pubic ramus just medial to the anterior inferior iliac spine (AIIS). Group B: (n = 15) patients received sciatico-femoral block with a mixture of 20 mL 0.125% bupivacaine with 4 mg dexamethasone injected in the femoral and sciatic nerve. Postoperative VAS scores, the time to first analgesic request was and the total morphine consumed as rescue analgesic were recorded. Results: Time to first analgesic request was significantly prolonged in group B than group A (P < 0.001). Total morphine dose in first 24 h postoperative and in first 48 h postoperative were significantly lower in group B than in group A (P < 0.001 and 0.003 respectively). VAS scores were significantly lower at 2, 4 and 8 h in group B than group A (P < 0.05) and were insignificantly different at 12, 24 h, and on 2nd and 7th day between the two groups. Phantom limb syndrome frequency was significantly lower at 1, 2, 3 and 6 months in group B than in group A (P < 0.05); at 6 mo it was noted in 10 (66.67%) patients in group A and 4 (26.67%) in group B with 2.5 (1:6.23) RR (95% CI) (P = 0.028). Conclusions: Sciatico-femoral block has better outcomes than pericapsular nerve block in patients undergoing above knee amputation regarding analgesic effect and the development of phantom limb syndrome. Abbreviations: AIIS - Anterior Inferior Iliac Spine; PNGB - Pericapsular Nerve Group Block; PLP - Phantom Limb Pain; SFB - Sciatic–Femoral Nerve Block; VAS – Visual Analog Scale Key words: Above Knee Amputation; Peri Capsular Nerve Group Block; Post Amputation Syndrome; Sciatico-femoral Nerve Block Citation: Bakeer AHMH, Hussien AIH, Abd El Aziz El Shaikh SM, Soliman Idris AM. The incidence of post amputation syndrome after pericapsular nerve group block versus sciatico-femoral nerve block in patients undergoing above knee amputation. Anaesth. pain intensive care 2022;27(2):665−672; DOI: 10.35975/apic.v27i2.2356 Received: May 11, 2023; Revised: September 08, 2023; Accepted: September 17, 2023

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Section: Shamim Et Al (2018)mentioning

confidence: 91%

Section: Shamim Et Al (2018)mentioning

confidence: 99%