Evaluation of age-based local anaesthetic dosing of bupivacaine for popliteal sciatic nerve block in children undergoing foot and ankle surgery: A prospective single arm interventional study

Autor: Srinivasan Parthasarathy, T Kumar Venkatesh, Balachandar Saravanan
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Indian Journal of Anaesthesia, Vol 67, Iss 16, Pp 257-260 (2023)
Druh dokumentu: article
ISSN: 0019-5049
0976-2817
DOI: 10.4103/ija.ija_171_23
Popis: Background and Aims: Recommendations on paediatric single-injection local anaesthetic (LA) dosing for peripheral nerve blocks (PNBs) are based on the children's weight and limited by weight-based toxicity concerns. In this study, we assessed the extent of circumferential spread and block characteristics following the injection of an age-based volume (age in years = LA volume) of 0.25% bupivacaine following popliteal sciatic nerve block (PSNB). Methods: Thirty children aged between 2 and 12 years with the American Society of Anesthesiologists (ASA) physical status I and II and undergoing foot and ankle surgical procedures were given single-injection ultrasound-guided subparaneural PSNB using 0.25% bupivacaine at age-based LA volume after the administration of anaesthesia. The circumferential pattern of LA spread (primary objective) was assessed along the nerve (both cephalad and caudal) using ultrasound from the point of administration and the block characteristics in terms of duration of sensory block. Results: The mean [standard deviation (SD)] cephalic circumferential LA spread distance was 2.52 (0.68) [95% confidence interval (CI): 2.27–2.76] cm. The mean (SD) caudal circumferential LA spread distance was 2.27 (0.48) [95% CI: 2.09–2.44] cm. The mean (SD) duration of the sensory block was 9.03 (0.97) [95% CI: 8.67–9.38] h. Conclusion: The age-based LA volume of bupivacaine for ultrasound-guided PSNB resulted in a longitudinal circumferential spread of around 4.7 cm (adding both cephalic and caudal spread) and provided adequate analgesia for nine postoperative hours.
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