Tibial and Common Fibular Nerve Block in the Popliteal Fossa with Single Puncture Using Percutaneous Nerve Stimulator: Anatomical Considerations and Ultrasound Description

Autor: Neuber Martins Fonseca, Beatriz Lemos da Silva Mandim, Rodrigo Rodrigues Alves, Roberto Araújo Ruzi, Raphael de Almeida Carvalho, Viviane de Oliveira Rangel
Jazyk: angličtina
Předmět:
Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Percutaneous
Popliteal fossa
medicine.drug_class
medicine.medical_treatment
Anesthesia
conduction

Punctures
ANATOMIA: Nervo tibial
nervo fibular

EQUIPAMENTOS: Ultrassom
Medicine
Humans
Prospective Studies
Tibial nerve
Ultrasonography
Interventional

Ultrasonography
ANATOMÍA: Nervio tibial
Fibular común
EQUIPOS: ultrasonido

business.industry
Local anesthetic
Ultrasound
Peroneal Nerve
Nerve Block
musculoskeletal system
Surgery
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Levobupivacaine
TÉCNICAS ANESTÉSICAS: Regional
nervos periféricos e gânglios
fibular comum
tibial

TÉCNICAS ANESTÉSICAS: Regionale
nervios periféricos y ganglios
fibular común
tibial

Nerve block
Transcutaneous Electric Nerve Stimulation
Female
Tibial Nerve
business
Nerve stimulator
medicine.drug
Zdroj: Brazilian Journal of Anesthesiology. (5):533-543
ISSN: 0034-7094
DOI: 10.1016/S0034-7094(11)70064-2
Popis: BACKGROUND AND OBJECTIVES: Techniques of peripheral nerve block have gained popularity over the last two decades becoming a growing anesthetic option for limb surgeries. This study proposes a technical approach of the tibial and common fibular nerves in the popliteal fossa with single puncture using percutaneous nerve stimulator, considering the correlation with an anatomical and ultrasound study. METHODS: This prospective, observational, randomized study was performed with 28 patients scheduled for foot surgeries. After localizing the tibial and common fibular nerves through percutaneous stimulation, the puncture was performed at the point of tibial nerve stimulation with a 5-cm needle (B.Braun, Stimuplex 50), and 10 mL of levobupivacaine were injected. The needle was pulled back and redirected to the point of common fibular nerve stimulation looking for the corresponding motor response, and 10 mL of the local anesthetic were injected. Imaging study of the popliteal region was performed by ultrasound to correlate the anatomy with the technique used. RESULTS: Adequate anesthesia was obtained in all cases. The mean time to localize the tibial and common fibular nerves suing the percutaneous stimulator was 57.1 and 32.8 seconds, respectively, and with the nerve stimulator it was 2.22 and 1.79 minutes, respectively. The mean depth of the needle into the tibial nerve was 10.7 mm. CONCLUSIONS: The approach for tibial and common fibular nerves with single puncture in the popliteal fossa using peripheral nerve stimulator is a good option for anesthesia and analgesia for foot surgeries.
Databáze: OpenAIRE
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