[Comparison of 4 techniques for internal saphenous nerve block]

Area of Science:

• Anesthesiology
• Surgical Procedures
• Pain Management

Background:

• The saphenous nerve is crucial for foot surgery anesthesia.
• Effective internal saphenous nerve blockade is essential for successful foot and ankle procedures.
• Comparing different block techniques is vital for optimizing anesthetic outcomes.

Purpose of the Study:

• To evaluate and compare the efficacy of four distinct techniques for internal saphenous nerve blockade.
• To determine the most successful method for internal saphenous nerve block using 1.5% mepivacaine.
• To assess patient tolerance and discomfort associated with each block technique.

Main Methods:

• Eighty patients undergoing foot surgery were randomized into four groups (n=20 each).
• Techniques included paravenous, transsartorial, femoral nerve approach (inguinal region with nerve stimulator), and subcutaneous infiltration.
• Block success was verified by pinprick test; cuff tolerance and discomfort were also recorded.

Main Results:

• The femoral nerve approach yielded the highest success rate (95%), significantly outperforming other methods (P < 0.05).
• Success rates for other techniques were: paravenous (60%), transsartorial (50%), and subcutaneous infiltration (45%).
• The femoral nerve approach also demonstrated superior pressure cuff tolerance (100%) and less patient discomfort.

Conclusions:

• The femoral nerve approach in the inguinal region is the most effective technique for internal saphenous nerve blockade.
• This method provides a higher success rate and better patient experience compared to paravenous, transsartorial, or subcutaneous infiltration techniques.
• Nerve stimulator-guided femoral approach offers a reliable option for internal saphenous nerve block.