Regional Block Anaesthesia - How Effective is it for Extremity Trauma?

Abstract

Regional block anaesthesia (RBA) techniques are eclipsed by the widespread use of general anaesthesia (GAl, espedally in trawna surgery. Thls Is despite the numerous advantages that regional blocks have to offer. We conducted a !t1Udy to evaluate efIlcaey, safety and feasibility of RBA in lsolated extremity trauma in war scenario, A prospective study was carried out over a period of eight months. There were a IoIaI of 96 patients with splinter, mine blast and gun shot wounds. Supraclavicular or axillary brachial block was employed for upper extremity surgery. 3 In 1 femoral block with classical sdatic block al hip or popUteal ' 08S8 was administered for lower limb operations. AU patients were stabilized prior to the procedure. A combination of lIgnoeaine 3 mglkg of 2% and huplvacaine 1.5 mglkg of 0.5% with dilution to make a volume of 0.75 mlIkg was employed. Assessment was made for onset, duration and degree of anaesthesia. Haemodyna.mk parameters and oxygen saturation were measured dUriDa the peritrau. matk period. 92.5% cases had good molor and sensory anaesthesia and permitted unhindered surgery without supplemmtation. The rest required GAJdlssociative anaesthesia (DA). Post operative pain relief lasted for an average of 4-5 hours. No patient had derangement of haemodynamic parameters or oxygen saturation. There was no systemic drug toxlclty, iocaI compUtations or mortaUty In our series. We found RBA for isolated extremity trauma to be simple, safe and effective with consistent results. MJAF12002; 58: 205·209

Orthopedic Surgeries of Lower Limb under Combined Femoral and Sciatic Nerve Block: A Comparative Study in RMCH & RC

“…Aksoy et al compared continuous spinal and peripheral nerve block in hip replacement surgery. [19] Mehourotra S. compared 3 in 1 femoral with sciatic nerve block over GA. [20] Patients with cardiovascular instability and anticoagulatent therapy can undergo lower extremity surgery under combined femoral and sciatic nerve block safely. In our study one patient in group A was having low cardiac output and safely operated without any complications with combined block.…”

Ultrasound‐guided femoral and sciatic nerve block as an option for below‐knee amputation in an elderly patient: A case report

“…Also, Mehourotra and Mehourotra 13 compared 3 in 1 femoral with sciatic nerve block over GA in isolated lower limb surgery in the trauma patient and found nerve blocks to be a safe alternative with lesser hemodynamic fluctuations in trauma patients. Similarly, in a study conducted by Tantry et al 14 in patients taking antiplatelet and antithrombotic drugs with severe valvular heart disease who underwent lower limb surgeries under combined femoral and sciatic nerve block, no complications were noted intra‐ and postoperatively.…”

Lower limb surgeries under combined femoral and sciatic nerve block

“…Various studies were conducted regarding the safety of combined femoral and sciatic nerve block over general and central neuraxial blocks for lower limb surgeries. Mehourotra and Mehourotra[ 8 ] compared 3 in 1 femoral with sciatic nerve block over GA in isolated lower limb surgery in the trauma patient. Aksoy et al .…”