Ultrasound-Guided Transgluteal Sciatic Nerve Block for Gluteal Procedural Analgesia

Selame, Lauren Ann; McFadden, Kathleen; Duggan, Nicole; Goldsmith, Andrew J.; Shokoohi, Hamid

doi:10.1016/j.jemermed.2020.10.047

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…The VAS scores of the experimental group were better than those of the control group on the day after surgery, one day after surgery, two days after surgery, and three days after surgery, with significant differences (P < 0:05). This point was also mentioned in the article of Selame et al [21]. The application of ultrasound guidance in sciatic nerve block anesthesia can improve the safety of the block and the success rate of the block.…”

Section: Discussionmentioning

confidence: 74%

Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery

Liu

Zhou

et al. 2022

Computational and Mathematical Methods in Medicine

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This research was aimed at analyzing the role of ultrasound-guided nerve block based on intelligent three-dimensional (3D) reconstruction algorithm in intraoperative anesthesia and postoperative analgesia of orthopedic surgery. 68 elderly patients were undergoing orthopedic surgery on the lower extremities, and they were randomly rolled into two groups with 34 patients in each group. The patients in control group received sciatic nerve block anesthesia (SNBA), and the patients in the experimental group received ultrasound-guided SNBA (UG-SNBA) under 3D reconstruction algorithm to analyze and compare the anesthesia effect and the postoperative analgesia effect. The results showed that compared with other algorithms, the evaluation index of ultrasound images processed by the 3D reconstruction algorithm was better. In terms of anesthesia effect, there was no significant difference in systolic blood pressure, diastolic blood pressure, and heart rate between the two groups before surgery ( P > 0.05 ). Intraoperative and postoperative indicators of the experimental group were significantly better than those of the control group; the drug dosage (61 mg) was less than that of the control group (78 mg). In addition, the onset time of anesthesia, the time of pain blockade, and the postoperative awake time (5 minutes, 8 minutes, and 8 minutes, respectively) were shorter than those in the control group (13 minutes, 15 minutes, and 15 minutes, respectively). The visual analogue scale (VAS) scores of the experimental group were better than those of the control group on the day after surgery, one day after surgery, two days after surgery, and three days after surgery, with significant differences ( P < 0.05 ). In summary, 3D reconstruction algorithm-based ultrasound image effect was clearer, the effect of UG-SNBA was more stable, and the postoperative analgesic effect was better. This work provided a higher reference for the selection of safe and effective anesthesia options in orthopedic surgery.

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Section: Discussionmentioning

confidence: 74%

Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery

Liu

Zhou

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Anatomical variations of the SN in relation to the PM have been described for many years and the possible implications these variations might play in certain pathologies. The correct identification of the anatomical variations in the population are important to identify patients for correct medical care, as the SN block is routinely used for anesthesia and analgesia during foot and ankle surgery, as also for minimally invasive techniques to provide neurostimulation therapies for chronic pain [ 2 , 3 , 4 , 5 ]. Ultrasound can be utilized to localize a specific nerve, view neighboring soft tissue anatomy, and plan a needle trajectory.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variations of the Sciatic Nerve Exit from the Pelvis and Its Relationship with the Piriformis Muscle: A Cadaveric Study

Reynoso

Ramirez

Nurmukhametov

et al. 2022

Neurology International

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Background: The sciatic nerve (SN) is the widest nerve of the human body that exits the pelvis through the greater sciatic foramen, usually below the piriformis muscle (PM), and descends between the greater trochanter of the femur and ischial tuberosity of the pelvis to the knee. The aim of this paper is to examine and identify the SN variations in relation to the PM, its prevalence, pattern, and course. Methods: A prospective-descriptive cross-sectional study was carried out to determine the frequency of anatomical variations in the exit of the SN in relation with the PM in 20 anatomical bodies (corpses) of both genders, in equal numbers. Results: The dissection of 40 SNs in corpses of both sexes in equal numbers showed that the SN exited inferior to the PM in 37 lower limbs (92.5%); between the fascicles of the PM and inferior to the PM in two lower limbs (5%); and in one thigh, between the fascicles of the PM and superior to the PM (2.5%). Our study reported that the SN divides in its terminal branches more commonly in the proximal part of the popliteal fossa in 55% of cases, in the gluteal region in 35% of cases, and in the middle third of the thigh in 10% of cases. Conclusions: Anatomical variations of the SN in relation to the PM are challenging for the diagnostic and therapeutic procedure in many clinical and surgical cases. Rapid recognition of the SN changes makes surgical approaches more accurate and effective. Our study confirmed that the SN exits the pelvis most commonly below the PM, although some anatomical variations may occur.

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“…Ultrasound-guided nerve blocks (UGNB) are a core element of this multifaceted approach to pain [6][7]. Although traditionally used by anesthesiologists for intraoperative anesthesia and the management of post-operative pain, targeted UGNB can also significantly reduce acute pain in ED patients [8][9][10][11][12][13][14][15][16][17][18]. When performed by trained EM physicians, UGNB may also decrease unintended side effects from opioids and procedural sedation, such as hypotension and respiratory depression [19][20].…”

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confidence: 99%

Ultrasound-Guided Nerve Blocks: Suggested Procedural Guidelines for Emergency Physicians

Brown

Goldsmith

LaPietra³

et al. 2022

pocus

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Acute pain is one of the most frequent, and yet one of the most challenging, complaints physicians encounter in the emergency department (ED). Currently, opioids are one of several pain medications given for acute pain, but given the long-term side effects and potential for abuse, alternative pain regimens are sought. Ultrasound-guided nerve blocks (UGNB) can provide quick and sufficient pain control and therefore can be considered a component of a physician’s multimodal pain plan in the ED. As UGNB are more widely implemented at the point of care, guidelines are needed to assist emergency providers to acquire the skill necessary to incorporate them into their acute pain management.

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Ultrasound-Guided Transgluteal Sciatic Nerve Block for Gluteal Procedural Analgesia

Cited by 7 publications

References 9 publications

Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery

Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery

Anatomical Variations of the Sciatic Nerve Exit from the Pelvis and Its Relationship with the Piriformis Muscle: A Cadaveric Study

Ultrasound-Guided Nerve Blocks: Suggested Procedural Guidelines for Emergency Physicians

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