[Combined sciatic 3-in-1 block. Application in lower limb orthopedic surgery].

Area of Science:

• Anesthesiology
• Pharmacology

Context:

• The study investigates the safety and efficacy of increased lidocaine dosage in combined sciatic 3-in-1 blocks.
• Patient weight was categorized to assess dosage effects across different body masses.

Purpose:

• To evaluate if increasing the maximum prescribed lidocaine volume from 50 ml to 65 ml improves block success rates.
• To determine if higher lidocaine doses lead to toxic plasma levels.
• To identify any associated side effects.

Summary:

• A study involving 25 adult patients demonstrated that increasing lidocaine volume to 65 ml in sciatic 3-in-1 blocks resulted in successful neural blockade and prolonged postoperative analgesia.
• Plasma lidocaine levels remained within safe limits across all weight groups, with no statistically significant differences observed.
• One patient required general anesthesia due to intolerance to the Esmarch cuff, but overall, the increased dosage proved effective and safe.

Impact:

• The findings suggest that a higher lidocaine dosage (650 mg) can be safely administered for combined sciatic 3-in-1 blocks, enhancing clinical success.
• This research provides evidence for optimizing local anesthetic volumes to improve patient outcomes in regional anesthesia procedures.