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 |
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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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