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Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study
Liwei Wang1, Yinyin Qu1, Ying Deng1
1Department of Anesthesiology, Peking University Third Hospital, Peking University, Beijing, 100191, People's Republic of China.
Journal of Pain Research
|June 22, 2023
Summary
The adductor magnus muscle (AMM) approach effectively blocks the sciatic nerve for total knee arthroplasty patients. This ultrasound-guided technique provides a valuable option for postoperative pain management.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Ultrasound-Guided Procedures
Background:
- Sciatic nerve location deep in the thigh poses challenges for supine patients.
- The sciatic nerve is situated within the posterior intermuscular septum of the thigh, surrounding the adductor magnus muscle (AMM).
Purpose of the Study:
- To evaluate the efficacy of sciatic nerve block using local anesthetic injection into the posterior intermuscular septum of the thigh.
- To assess the novel "AMM approach" for sciatic nerve blockade.
Main Methods:
- Ultrasound-guided sciatic nerve block performed on 26 total knee arthroplasty patients.
- Injection of 20 mL 0.25% ropivacaine into the posterior AMM using the AMM approach.
- Simultaneous femoral nerve block with 20 mL 0.4% ropivacaine administered.
Main Results:
- Successful sciatic nerve blockade in all 26 patients.
- Rapid onset of sensory block (5.4 ± 1.9 min) and motor block (8.7 ± 3.5 min).
- Low requirement for rescue analgesics (19.2% within 24 hours).
Conclusions:
- The AMM approach is an effective and innovative method for sciatic nerve block.
- This technique, combined with femoral nerve block, offers a beneficial analgesic strategy for total knee arthroplasty.
