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Parasacral Sciatic Nerve Block

Lingmin Chen, Jin Liu, Jing Yang, Yanzi Zhang, Yue Liu
BACKGROUND AND OBJECTIVES: Selecting an appropriate anesthetic technique for patients with ankylosing spondylitis undergoing hip surgery is challenging because of a potentially difficult airway, the risk of cardiovascular and respiratory complications, and the technical difficulty of performing central neuraxial blocks in patients with ankylosing spondylitis. Our objective was to report a case in which combination neural blockade was used successfully in an elderly patient with ankylosing spondylitis undergoing hip fracture surgery...
March 2016: Regional Anesthesia and Pain Medicine
Ahmad Muhammad Taha, Mohammed Abd-Elfttah Ghoneim
BACKGROUND: Major lower limb nerve blocks are relatively safe techniques. However, their efficacy for hip hemiarthroplasty is unknown. The objective of this study was to determine the effectiveness of combined femoral, sciatic, obturator and lateral femoral cutaneous (LFC) nerve blocks in providing adequate anesthesia for hip hemiarthroplasty. MATERIALS AND METHODS: A total of 20 patients with fracture neck femur; who underwent hip hemiarthroplasty, participated in this observational study...
July 2014: Saudi Journal of Anaesthesia
Jennifer M Dillow, Randy L Rosett, Timothy R Petersen, Firoz S Vagh, James A Hruschka, Nicholas C K Lam
BACKGROUND: The parasacral (PS) approach to sciatic nerve blockade has the potential for safe and effective use in children, but has never been studied in this population. Its potential advantages include increased posterior cutaneous nerve block reliability, potential for hip joint analgesia, and decreased nerve depth, making ultrasound guidance easier. OBJECTIVE: To assess the efficacy of an ultrasound-guided PS sciatic nerve block in children. METHODS: Nineteen patients, 1-16 years old, scheduled for lower limb surgery with peripheral nerve blockade (PNB) were prospectively enrolled...
November 2013: Paediatric Anaesthesia
Younes Aissaoui, Issam Serghini, Youssef Qamous, Rachid Seddiki, Mohammed Zoubir, Mohammed Boughalem
PURPOSE: The ability of the parasacral sciatic nerve block (PSNB) to induce anesthesia of the obturator nerve remains controversial. Our objective was to evaluate the anesthesia of the obturator nerve after a PSNB. METHODS: Forty patients scheduled to undergo knee surgery (anterior cruciate ligament reconstruction) were included in this prospective, randomized, controlled study. Patients were randomized to receive PSNB alone (control group, n = 20) or PSNB in combination with an obturator nerve block (obturator group, n = 20)...
February 2013: Journal of Anesthesia
Ahmad Muhammad Taha
BACKGROUND: The purpose of this study was to describe detailed sonographic anatomy of the parasacral area for rapid and successful identification of the sciatic nerve. METHODS: Fifty patients scheduled for knee surgery were included in this observational study. An ultrasound-guided parasacral sciatic nerve block was performed in all patients. The ultrasound probe was placed on an axial plane 8 cm lateral to the uppermost point of the gluteal cleft. Usually, at this level the posterior border of the ischium (PBI), a characteristically curved hyperechoic line, could be identified...
March 2012: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
G Danelli, D Ghisi, F Bellinghieri, B Borghi, G Fanelli, J E Chelly
BACKGROUND: This prospective, randomized, observer-blinded, pilot study compares the effects of the nerve stimulation guidance technique (NS) with the loss of resistance technique (LOR) on readiness for surgery during the posterior approach to lumbar plexus block. METHODS: Thirty ASA status I-III patients who were 18-85 years old and who were undergoing hip fracture repair were enrolled. After parasacral sciatic nerve block, patients were randomly allocated to receive a continuous posterior lumbar plexus block using nerve stimulation (n=15) or a continuous psoas compartment block using the loss of resistance technique (n=15) with 20 ml of 1...
October 2011: Minerva Anestesiologica
Diego A Portela, Pablo E Otero, Lisa Tarragona, Angela Briganti, Gloria Breghi, Pierre Melanie
OBJECTIVE: To evaluate the effectiveness of paravertebral lumbar plexus block combined with parasacral sciatic block to anesthetize one hind limb in awake dogs. STUDY DESIGN: Randomized, controlled, blinded experimental study. ANIMALS: Eight healthy mongrel dogs weighing 12.4 ± 4.5 kg and aged 7 ± 2.33 years. METHODS: After sedation with medetomidine, dogs received B1: bupivacaine 0.25%, 0.2 mL kg(-1), B2: bupivacaine 0...
November 2010: Veterinary Anaesthesia and Analgesia
Wafik A Amin, Mohamad Osama Abou Seada, Mervat F Saeed, Sohair F Mohammad, Talaat M Abdel-Haleem, Emad A Shabaan
OBJECTIVE: The aim of the present study was to evaluate the ease and reliability of the anterior and lateral approaches to sciatic nerve block compared to the posterior parasacral approach, and their suitability for the specific factors in the patients, positions, and surgeries. Also, the insertion and usefulness of the continuous catheter technique was evaluated. METHODS: The study was carried out on 120 patients, ASA I, II and III, of both genders, age range between 20 and 70 years, scheduled for orthopedic, general and vascular lower limb surgery...
June 2010: Middle East Journal of Anesthesiology
Thomas Le Corroller, Rodolphe Wittenberg, Vanessa Pauly, Nicolas Pirro, Pierre Champsaur, Olivier Choquet
BACKGROUND: Sciatic nerve block is a commonly used technique for providing anesthesia and analgesia to the lower extremity. At the parasacral level, the nerve block is classically performed via a posterior approach in lateral decubitus position causing patient's discomfort. Therefore, we aimed to conduct an anatomical study describing a new lateral approach to the parasacral sciatic nerve in supine position. METHODS: The skin entry point was located on the vertical line through the greater trochanter (GT) at the midpoint between the anterior superior iliac spine (ASIS) level and the GT...
March 2011: Surgical and Radiologic Anatomy: SRA
L Bouattour, N Ben Abbes, A Essefi, M Derbel, F Gargouri, Y Bouaziz, A Ghorbel, S Maatoug, H Keskes, A Karoui
INTRODUCTION: The usual technique of parasacral sciatic nerve block seems an approach easily achieved, however, the ischial tuberosity is difficult to palpate. [1] The purpose of the study was to propose new skin landmarks improved by an anatomical and clinical study. PATIENTS AND METHODS: Three cadaver dissections made previously have shown that our skin landmarks appeared correct. Twenty consenting patients, ASA I to III, proposed for lower limb surgery, were included in this descriptive and prospective study...
January 2010: Annales Françaises D'anesthèsie et de Rèanimation
Pablo Escovedo Helayel, Diogo Brüggemann da Conceição, Julian Alexander Knaesel, Maurício Sperotto Ceccon, Adilson José Dal Mago, Getúlio Rodrigues de Oliveira Filho
BACKGROUND AND OBJECTIVES: The volume and mass of local anesthetics (LA) affect the success rate of peripheral nerve blocks. Thus, the main objective of this study was to determine the volumes of local anesthetics in parasacral and infragluteal-parabiceps sciatic nerve block (SNB). METHODS: One hundred and one patients undergoing infragluteal-parabiceps or parasacral SNB with 0.5% ropivacaine or 0.5% bupivacaine with 5 microg.mL-1 of adrenaline were randomly divided into 4 groups...
September 2009: Revista Brasileira de Anestesiologia
Alon Y Ben-Ari, Rama Joshi, Anna Uskova, Jacques E Chelly
In this report, we describe the feasibility of locating the sacral plexus nerve using a parasacral approach and an ultrasound-guided technique. The parasacral region using a curved probe (2-5 MHz) was scanned in 17 patients in search of the medial border of the ischial bone and the lateral border of the sacrum, which represent the limit of the greater sciatic foramen. In addition, attempts were made to identify the piriformis muscles and the gluteal arteries. The sacral plexus was identified at the level of the sciatic foramen as a round hyperechoic structure...
June 2009: Anesthesia and Analgesia
Pablo Escovedo Helayel, André Roberto Bussman, Diogo Brüggemann da Conceição, Getúlio Rodrigues de Oliveira Filho
BACKGROUND AND OBJECTIVES: Local anesthetics (LA) are safe drugs when the proper dose and localization are used. The rate of absorption of the local anesthetic depends on its mass and blood flow at the site of the injection. The objective of this study was to analyze the plasma concentration of 50% enantiomeric excess (S75R25) 0.5% bupivacaine combined with 1:200,000 epinephrine in the parasacral (PS) and infragluteal (IG) sciatic nerve block (SNB). METHODS: Twenty-eight patients scheduled for ankle and foot surgeries were randomly divided into two groups in this prospective study...
July 2008: Revista Brasileira de Anestesiologia
Maeve O'Connor, Margaret Coleman, Fintan Wallis, Dominic Harmon
BACKGROUND: The parasacral approach to sciatic blockade is reported to be easy to learn and perform, with a high success rate and few complications. METHODS: Using magnetic resonance imaging, we evaluated the accuracy of a simulated needle (perpendicular to skin) in contacting the sacral plexus with this approach in 10 volunteers. Intrapelvic structures encountered during the simulated parasacral blocks were also recorded. RESULTS: The sacral plexus was contacted by the simulated needle in 4 of the 10 volunteers, and the sciatic nerve itself in one volunteer...
May 2009: Anesthesia and Analgesia
Nathalie Valade, Jacques Ripart, Emmanuel Nouvellon, Philippe Cuvillon, Dominique Prat-Pradal, Jean-Yves Lefrant, Jean-Emmanuel de la Coussaye
BACKGROUND: The ability of parasacral sciatic nerve block to provide consistent obturator nerve and perineal blockade remains undetermined. In this anatomic work, we assessed the spread of a colored latex mimicking a parasacral injection, and observed the spread to the obturator nerve and sacral nerve roots. METHODS: Fourteen parasacral injections were performed bilaterally on seven human cadavers. Dissection was performed in two steps. First, the posterior approach confirmed the presence of dye on the sciatic nerve at the level of the piriformis muscle to define the success of the injection...
February 2008: Anesthesia and Analgesia
Bénédicte S Hagon, Omar Itani, Jawad Hosseini Bidgoli, Philippe J Van der Linden
BACKGROUND: In this prospective, randomized, double-blind study, we compared the tibial and the peroneal evoked motor response with regard to efficacy of sciatic nerve block using the parasacral approach. METHODS: Twenty-six ASA I-III patients scheduled for elective lower limb surgery were randomized to receive a parasacral sciatic block, using a nerve stimulator technique seeking either a tibial (n = 14) or peroneal (n = 12) motor response. After the evoked motor response was obtained, a solution of 10 mL 2% lidocaine with epinephrine and 10 mL 0...
July 2007: Anesthesia and Analgesia
Pablo E Helayel, Maurício S Ceccon, Julian A Knaesel, Diogo B Conceição, Getúlio R de Oliveira Filho
OBJECTIVE: The authors describe the occurrence of urinary incontinence after bilateral parasacral sciatic-nerve blocks. CASE REPORT: Two female patients scheduled for bilateral hallux valgus corrective surgery under bilateral parasacral sciatic-nerve block developed urinary incontinence manifested by 3 episodes of enuresis in the first 5 hours after surgery. Physical examination revealed bilateral perineal and gluteal anesthesia and no bladder distention in both patients...
July 2006: Regional Anesthesia and Pain Medicine
Yasuhiro Asao, Tomoyasu Higuchi, Noriko Tsubaki, Yutaka Shimoda
We experienced four cases of anesthesia for hip fracture reduction in patients with severe heart failure, where anesthesia was attempted with combined paravertebral lumbar plexus and parasacral sciatic nerve block instead of spinal anesthesia. The anesthesia was successful without any sequelae. The patients' characteristics are as follows. Case 1: 97-year-old woman with severe heart failure and old myocardial infarction. Case 2: 91-year-old man with pacemaker, heart failure and heart valve disease. Case 3: 93-year-old woman with severe heart failure and multi-vessel coronary artery stenosis...
June 2005: Masui. the Japanese Journal of Anesthesiology
Jacques Ripart, Philippe Cuvillon, Emmanuel Nouvellon, Elisabeth Gaertner, Jean-Jacques Eledjam
BACKGROUND AND OBJECTIVES: Parasacral sciatic nerve block has been shown to be easy to perform, but studies reported to date involve a total of only 155 patients. The aim of this study was to assess the efficacy of parasacral sciatic nerve block in a larger group of patients. METHODS: Four hundred consecutive parasacral blocks were evaluated prospectively. The level of expertise of the practitioner, the time to perform the block, the lowest current intensity of nerve stimulation, the injected volume, the onset time, the success or failure of the block, and complications were recorded...
March 2005: Regional Anesthesia and Pain Medicine
Denis Jochum, Gabriella Iohom, Olivier Choquet, Dioukamady Macalou, Samba Ouologuem, Pascal Meuret, Freddy Kayembe, Michel Heck, Paul-Michel Mertes, Hervé Bouaziz
Our aim was to objectively evaluate the efficacy of obturator nerve anesthesia after a parasacral block. Patients scheduled for knee surgery had a baseline adductor strength evaluation. After a parasacral block with 30 mL 0.75% ropivacaine, sensory deficit in the sciatic distribution (temperature discrimination) and adductor strength were assessed at 5-min intervals. Patients with an incomplete sensory block (defined as a temperature discrimination score of less than 2 in the 3 cutaneous distributions of the sciatic nerve tested) 30 min after the parasacral block were excluded from the study...
November 2004: Anesthesia and Analgesia
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