Intraneural Ultrasound-guided Sciatic Nerve Block: Minimum Effective Volume and Electrophysiologic Effects

Anesthesiology
Gianluca CappelleriGiorgio Francesco Danelli

Abstract

WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Both extra- and intraneural sciatic injection resulted in significant axonal nerve damage. This study aimed to establish the minimum effective volume of intraneural ropivacaine 1% for complete sensory-motor sciatic nerve block in 90% of patients, and related electrophysiologic variations. Forty-seven consecutive American Society of Anesthesiologists physical status I-II patients received an ultrasound-guided popliteal intraneural nerve block following the up-and-down biased coin design. The starting volume was 15 ml. Baseline, 5-week, and 6-month electrophysiologic tests were performed. Amplitude, latency, and velocity were evaluated. A follow-up telephone call at 6 months was also performed. The minimum effective volume of ropivacaine 1% in 90% of patients for complete sensory-motor sciatic nerve block resulted in 6.6 ml (95% CI, 6.4 to 6.7) with an onset time of 19 ± 12 min. Success rate was 98%. Baseline amplitude of action potential (mV) at ankle, fibula, malleolus, and popliteus were 8.4 ± 2.3, 7.1 ± 2.0, 15.4 ± 6.5, and 11.7 ± 5.1 respectively. They were significantly reduced at the fifth week (4.3 ± 2.1, 3.5 ± 1.8, 6.9 ± 3.7, and 5.2 ± 3.0) and at the sixth month (5.9 ...Continue Reading

References

Sep 19, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·J Kimura
Mar 14, 2002·Biometrics·Mario Stylianou, Nancy Flournoy
Nov 20, 2002·Anesthesiology·Gretchen Henkel
Feb 19, 2003·Statistics in Medicine·Mario StylianouNancy Flournoy
Jul 18, 2009·Anesthesia and Analgesia·Christopher RobardsXavier Sala-Blanch
Dec 24, 2009·British Journal of Anaesthesia·T SteinfeldtJ Graf
Dec 4, 2010·Anesthesia and Analgesia·Thorsten SteinfeldtJürgen Graf
Jan 29, 2011·Regional Anesthesia and Pain Medicine·De Q H TranRoderick J Finlayson
Oct 12, 2014·Regional Anesthesia and Pain Medicine·Theodosios SaranteasDe Q H Tran

❮ Previous
Next ❯

Citations

Jul 19, 2018·Anesthesiology·Jonathan P Wanderer, James P Rathmell
Jun 23, 2018·Anesthesiology·Kamen VlassakovJames P Rathmell
May 16, 2019·Anesthesiology·Xin JiangHongbin Yuan
May 16, 2019·Anesthesiology·Jeffrey D SwensonJennifer J Davis
May 16, 2019·Anesthesiology·Yan H Lai, Meg A Rosenblatt
May 16, 2019·Anesthesiology·Gianluca Cappelleri, Marco Gemma
Aug 7, 2020·Minerva anestesiologica·Marco CascellaFranco Marinangeli
Aug 14, 2020·Anaesthesia Critical Care & Pain Medicine·Mathieu CapdevilaXavier Capdevila

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.