This article is more than 5 years old. Information may no longer be current.
Nerve blocks placed with ultrasound guidance yield 99% success rate
Click Here to Manage Email Alerts
VANCOUVER, British Columbia — Using ultrasound guidance for the placement of sciatic nerve block injections at the popliteal fossa is effective, according to the results of a study presented here.
“Ultrasound guidance is a safe and reliable method for needle localization of popliteal fossa blocks,” Kenneth J. Hunt, MD, said during his presentation at the 25th Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society.
“The location of the needle within the compartment is adequate. It does not necessarily need to stimulate or be next to the sciatic nerve. Regional block teams can be an effective way to get these blocks done efficiently and perhaps save time and money, and this may be a potential mode of primary anesthesia,” he said.
Hunt and his colleagues prospectively studied 200 consecutive patients undergoing various foot and ankle procedures. They received a single or continuous sciatic nerve block injection at the popliteal fossa placed using ultrasound guidance.
The investigators evaluated the patients preoperatively and postoperatively for block effectiveness, and at 10 to 14 days for signs of residual neurologic defects. They also instructed patients discharged with continuous-injection catheters to call the senior anesthesiologist if they had any questions or problems.
The researchers defined block failure as an incomplete motor or sensory blockade at examination, and noted any instances of needle paresthesia, vessel puncture, injection site infection, or residual neurologic deficits.
“Our success rate was about 99%,” Hunt said. The one failure occurred in the catheter group, and the patient was successfully re-blocked.
In addition, the investigators found no needle paresthesia, neurologic deficits, vessel punctures or intravascular injections.
Hunt cited the lack of a control group as a study limitation and noted that the blocks were not used as a primary method of anesthesia.
Reference:
- Hunt KJ, Beals T, Nichish F, et al. Analgesia for foot and ankle surgery with sciatic nerve block using ultrasound guidance: A prospective study of 200 patients. Presented at the 25th Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society. July 15-18, 2009. Vancouver, British Columbia.