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Updated: Feb 6, 2026

Reverse Total Shoulder Arthroplasty
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Continuous psoas sciatic blockade for total knee arthroplasty.

Wesameldin A Sultan1, Ezzeldin S Ibrahim1, Mohamed S El-Tahawy2

  • 1Department of Anaesthesia, Menoufia University, Shebeen-El-Kom, Egypt.

Saudi Journal of Anaesthesia
|August 14, 2018
PubMed
Summary
This summary is machine-generated.

Psoas sciatic block offers safe anesthesia for total knee surgery, providing longer pain relief with fewer hemodynamic changes compared to combined spinal epidural anesthesia.

Keywords:
Combined spinal epiduralknee arthroplastypsoas sciatic blockade

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Regional Anesthesia

Background:

  • Psoas sciatic block (Pso/Sci) is an advanced anesthetic technique for lower extremity procedures.
  • It offers an alternative to general anesthesia or central neuraxial blockade, particularly beneficial for patients with comorbidities.

Purpose of the Study:

  • To compare the efficacy of combined Pso/Sci as a sole anesthetic technique versus conventional combined spinal epidural (CSE) anesthesia.
  • The study focused on patients undergoing total knee arthroplasty.

Main Methods:

  • Eighty patients undergoing total knee replacement were randomized into two groups: Pso/Sci and CSE.
  • Ultrasound-guided continuous Pso/Sci was administered to one group, while the other received CSE anesthesia.
  • Key metrics included block onset, hemodynamic changes, contralateral spread, time to first analgesic request, complications, and satisfaction.

Main Results:

  • Pso/Sci demonstrated a significantly longer block time and delayed onset of sensory and motor block.
  • The first analgesic request was significantly later in the Pso/Sci group.
  • While hemodynamic changes occurred in the CSE group, they were insignificant compared to the Pso/Sci group. No significant differences were noted in complications or satisfaction.

Conclusions:

  • Psoas sciatic block is a safe and effective alternative anesthetic technique for total knee surgery.
  • It provides adequate anesthesia with reduced hemodynamic alterations.
  • This technique is a viable option for patients requiring lower extremity surgical anesthesia.