International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 6, Issue 8 (2020)

Comparative study of anterior and posterior approaches for sciatic nerve block for lower limb and foot surgery in diabetic patients


Seema Yadav, Rajendra Verma, Rajendra Kumar Pipal

Background: Sciatic nerve block (SNB) is an established technique of anaesthesia for lower limb and foot surgeries. Although several approaches to SNB have been described not a single one is ideal in all respect. We aimed to compare commonly used two approaches to SNB to fin d out which one is better with regard to efficacy and patient satisfaction. Methods: Consented 100 diabetic patients of ASA grade II, III posted for foot and /or lower limb surgery were randomly allocated to receive SNB by either anterior (n=50) or posterior (n=50) approach. Blocks were performed utilizing peripheral nerve stimulator (PNS), with 25 ml of local anaesthetic mixture (10 ml of 2% lignocaine with adrenaline and 15 ml of 0.5% bupivacaine). Time taken to perform block with number of attempts required, onset of sensory and motor block, duration of analgesia were record ed and compared. We also had compared comfort level of the patients. Results: Time taken to perform anterior approach was significantly less (p< 0.05) when compared to posterior approach. Patients were comfortable with anterior approach than that of posterior. Faster onset of sensory and motor block, and more duration of analgesia was observed with the posterior group but the difference was not statistically significant. Conclusion: Our study concluded that though efficacy of both the anterior and posterior approaches to block sciatic nerve was same, anterior approach is easier than posterior approach as it requires lesser time to perform and gives far better patient comfort
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