Continuous sciatic block for leg and foot surgery in 160 children

Vas, Lakshmi

doi:10.1111/j.1460-9592.2005.01620.x

Cited by 30 publications

(16 citation statements)

References 27 publications

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“…The fact that variability already exists at birth (Fig. ) would also explain the incidence of block failures (up to 14%) when using ‘blind techniques’ in children (Vas, ). This finding also explains the relative clinical usefulness of mathematical formulas based on direct external anatomical references (Bernière et al.…”

Section: Discussionmentioning

confidence: 99%

Anatomical comparison of sciatic nerves between adults and newborns: clinical implications for ultrasound guided block

et al. 2013

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The sciatic nerve (SN) is easily blocked under ultrasound guidance by identifying either the SN common trunk or its two components: the tibial nerve (TN) and the common peroneal nerve (CPN). The authors investigate whether there are anatomical differences between newborns and adults. The SN, TN and CPN of both lower extremities in 24 (11 neonatal and 13 adults) formolized cadavers were dissected. Distances were measured from the origin of the SN (passing under the piriformis muscle) to its division into TN and CPN, and from there to the popliteal crease. The sciatic/thigh coefficient (proportion relating SN length to thigh length) and the variation coefficient for the SN were calculated. The distance from the popliteal crease to the SN division was significantly shorter in neonates than in adults (1.04 AE 0.9 cm vs. 5.6 AE 5.1 cm, P = 0.0003). In addition, the neonatal SN divided at a proportionally more distal position in the thigh than it did in adults (86 AE 13 vs. 74 AE 15%, P = 0.0059). However, the coefficient of variation between the SN-division distances was not statistically different in infants and adults (12.8 vs. 18.2%, P = 0.4345). The variations in the point of SN division seen in the adult SN are already seen in the neonatal period, but in newborns the SN divided in a more distal position in relation to the thigh than in adults, so this finding of anatomical variability in neonates suggests that ultrasound guidance can be useful when performing a SN block in these small patients.

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Section: Discussionmentioning

confidence: 99%

Anatomical comparison of sciatic nerves between adults and newborns: clinical implications for ultrasound guided block

et al. 2013

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“…The proximal approaches include the proximal lateral approach (39,40) or the subgluteal approach (41–45). Continuous popliteal nerve block was compared with continuous epidural block in children undergoing major foot and ankle surgery (38). Both techniques were associated with excellent postoperative analgesia in this study, but continuous popliteal nerve block led to less urinary retention, less discontinuation of LA infusion, and less nausea and vomiting.…”

Section: Indications and Techniquesmentioning

confidence: 99%

Peripheral catheter techniques

Dadure¹,

Capdevila²

2011

Pediatric Anesthesia

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With ultrasound, continuous peripheral nerve blocks (CPNBs) are one of the most recent developments in regional anesthesia in children. CPNBs are now used more widely in children because more suitable materials have been marketed, allowing complete, and prolonged postoperative pain control. Their use after orthopedic procedures in children and treatment for complex regional pain syndrome in adolescents has demonstrated the benefits. Perineural catheters have also shown their superiority over other techniques of continuous regional anesthesia in terms of side effects. The efficiency and the safety of these techniques may facilitate early ambulation with improved pain management, treatment at home with disposable pumps, and improved rehabilitation of children. Studies on large cohorts of patients published to date have failed to highlight any severe complications in their use compared with other adult studies. Accidents owing to systemic toxicity are very unlikely if the recommended maximum dose is not exceeded. The safety of continuous regional anesthesia techniques in children relies on the use of low-concentration l-enantiomer solutions (ropivacaine or levobupivacaine) accompanied by low plasma concentrations of local anesthetics, limiting the risk of systemic toxicity of these molecules. CPNB can ensure strong and lasting analgesia in hospital or at home.

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“…Devamlı perinöral kateter teknikleri de çocuklarda son zamanlarda popüler olmaktadır (12,21). Kateter yerleştirilmesinde ki en önemli problem kateterin hedef sinir yapıya yeterli yakınlıkta olup olmadığıdır.…”

Section: Gereç Ve Yöntemlerunclassified

Ultrasound-guided regional anesthesia for orthopedic surgery in pediatric patients

Şahin¹,

Şahin²,

Aktas³

et al. 2011

Gaziantep Med J

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ÖzetUltrasonun (US) kullanıma girmesi pediatrik rejyonal anestezide çok önemli gelişmelere yol açmış ve US kılavuzluğu ile zor rejyonal uygulamalar dahi çocuklarda yapılabilir hale gelmiştir. Biz bu çalışmada kliniğimizde ortopedi ameliyat salonunda son 1 yılda opere edilen yaşları 1 ile 16 arasında değişen 81 pediatrik olguya intraoperatif anestezi, analjezi veya postoperatif analjezi amacıyla yaptığımız US kılavuzluğunda periferik sinir ve pleksus bloklarını literatür bilgileri ışığında tartışmayı amaçladık. Bu çalışma için hastaların anestezi formları, rejyonal anestezi değerlendirme formları, hemşire gözlem formları ve hastane çıkış epikrizleri kullanıldı. Hastaların bireysel özellikleri (yaş, cinsiyet, vücut ağırlığı, boy), ASA skorları, anestezi özellikleri, postoperatif analjezi ve motor blok süreleri, ve komplikasyonlar kaydedildi. Hastaların ortalama analjezi süresi üst ekstremite ve alt ekstremite için sırasıyla 5.8 ± 1.6 saat ve 8.7 ± 2.5 saat, motor blok süresi üst ekstremite ve alt ekstremite için sırasıyla 3.6 ± 0.7 saat ve 5.3 ± 1.8 saat olarak bulundu. Üç hastada başarısız veya yetersiz blok mevcuttu. Ortopedik cerrahi uygulanan pediatrik hastalarda rejyonal bloklar US-kılavuzluğunda etkin ve güvenli bir şekilde uygulanabilir ve yüksek başarı, minimal komplikasyon oranına sahiptir. Anahtar kelimeler: Ortopedik cerrahi; pediatrik; rejyonal anestezi; ultrason Abstract Introduction of the use of ultrasound (US) has led to very important developments in pediatric regional anesthesia and made applications, which are hard or even impossible to perform, applicable by the guidance of US. In this study, we aimed to discuss USguided peripheral nerve and plexus blocks that we made for intraoperative anesthesia, analgesia or postoperative analgesia in 81 pediatric patients ranging from ages 1 to 16 who were operated in the last year. For this study, anesthesia forms, evaluation forms of regional anesthesia, observation forms for nurses, and hospital epicrises of patients were used. Demographic data (age, sex, weigh, height), ASA scores, anesthetic properties, postoperative duration of analgesia and motor block and complications of patients were recorded. Estimated mean duration of analgesia for upper and lower extremities were 5.8 ± 1.6 h, and 8.7 ± 2.5 h, respectively, the duration of motor block for upper and lower extremities were 3.6 ± 0.7 h, 5.3 ± 1.8 h, respectively. Failed or insufficient block count was three. In orthopedic surgery applied pediatric patients US-guided regional blocks can be applied effectively and safely and it has high achievement and minimal complication rates.

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Continuous sciatic block for leg and foot surgery in 160 children

Cited by 30 publications

References 27 publications

Anatomical comparison of sciatic nerves between adults and newborns: clinical implications for ultrasound guided block

Anatomical comparison of sciatic nerves between adults and newborns: clinical implications for ultrasound guided block

Peripheral catheter techniques

Ultrasound-guided regional anesthesia for orthopedic surgery in pediatric patients

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