Ultrasound guided saphenous and sciatic nerve block for leg surgery - Trial PACTR201603001532179

Timeline & Enrollment

Summary

Leg surgery, especially tibial shaft fracture is one of the most common types of long-bone fractures in orthopedic practice. Reamed intramedullary nailing is now commonly performed in the management of tibial fractures and is considered to be the treatment of choice in closed displaced fractures.(4) Pain and postoperative nausea and vomiting (PONV) are the most common causes for hospital admission following ambulatory surgery. Therefore, finding techniques that facilitate rapid recovery and early discharge by providing excellent analgesia with minimal side effects is of critical importance.(2) The use of regional anesthesia and analgesia has increased for reasons of patient comfort and safety. Several advantages support its expanding use. The sciatic nerve provides sensory and motor innervation to the posterior thigh and posterior and lateral aspect of the leg and foot . When it is blocked at lower thigh level (distal sciatic), sufficient analgesia (or anesthesia) is provided to the posterior and lateral aspects of the lower thigh and leg (3).Sciatic nerve may be blocked either proximally or distally. Distal Sciatic nerve block which will be performed in our study requires less time to perform, requires fewer needle passes, causes less patient discomfort, and requires smaller doses of midazolam for procedural sedation.(1)The use of ultrasound guidance has provided an opportunity to perform many peripheral nerve blocks that used to be difficult to perform with other techniques, and has got more and more popular over the past decade. In recent years, the ultrasound technology has been used for peripheral nerve blocks for many types of peripheral nerve blocks in both adults and children(8). It has the advantages of increasing the success rate by easier identification of the site of the nerve, correct deposition of the local anesthetic around the nerve and decreases the incidence of complications associated with these blocks.

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