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Updated: Jun 6, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

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Published on: June 25, 2013

Hemodynamic changes during a combined psoas compartment-sciatic nerve block for elective orthopedic surgery.

Marcel A de Leeuw¹, Cornelis Slagt, Martijn Hoeksema

¹Department of Anesthesia, Intensive Care and Pain Medicine, Zaans Medical Centre, Zaandam, The Netherlands. madeleeuw@quicknet.n

Anesthesia and Analgesia

|December 16, 2010

Summary

A combined psoas compartment-sciatic nerve block (CPCSNB) did not significantly alter cardiac index in patients undergoing hip surgery. While blood pressure and heart rate changed, these variations were clinically acceptable, indicating CPCSNB is hemodynamically safe.

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Area of Science:

Anesthesiology
Cardiovascular Physiology

Background:

Combined psoas compartment-sciatic nerve block (CPCSNB) may influence hemodynamic variables due to local anesthetic absorption and vasodilation.
Assessing hemodynamic changes during CPCSNB is crucial for patient safety in orthopedic surgery.

Purpose of the Study:

To evaluate and document hemodynamic changes following CPCSNB in patients undergoing elective orthopedic surgery.
To determine the clinical significance of observed hemodynamic variations.

Main Methods:

Twenty patients undergoing total hip arthroplasty revision received CPCSNB with bupivacaine and epinephrine.
Hemodynamic parameters including cardiac index, mean arterial pressure, diastolic blood pressure, and heart rate were monitored pre- and post-block.

Main Results:

Cardiac index remained unchanged post-CPCSNB (2.98 vs. 2.99 l·min⁻¹·m⁻²).
A statistically significant reduction in mean arterial and diastolic blood pressure was observed.
Heart rate showed a statistically significant increase post-block.

Conclusions:

CPCSNB does not induce clinically significant changes in cardiac index.
Observed alterations in blood pressure and heart rate were within acceptable clinical limits (<10% variation).
CPCSNB appears to be hemodynamically safe for this patient group.