Comparison of unilateral spinal anaesthesia and popliteal sciatic nerve block in the elderly undergoing transmetatarsal amputation


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Abstract

Both unilateral spinal anaesthesia (USA) and politeal sciatic nerve block (PB) are effective anaesthetic techniques for ankle and foot surgery. In this study hemodynamic data, pain scores and side-effects of USA and PB in elderly patients undergoing transmetatarsal amputation were compared. Thirty ASA II-III randomly assigned patients (70-86 years) received either USA (n=15) or PB (n=15), each under standardized protocols. The results demonstrated that popliteal nerve block provided more stable hemodynamic profile and better postoperative pain control than unilateral spinal anaesthesia. Surgical anaesthesia was achieved in all 30 patients. No complications such as postdural puncture headache, backache, neurological complications or vomiting were noted.

About the authors

Renata Krobot

General Hospital Varazdin, Varazdin, Croatia

Отделение анестезиологии и интенсивной терапии

References

  1. Di Cianni S., Rossi M., Casati A., Cocco C., Fanelli G. Spinal anesthesia: an evergreen technique // Acta Biomed. 2008; 79: 9-17.
  2. Cook T. M., Counsell D., Wildsmith J.A.W. Major complications of central neuroaxial block: report on the Third National Audit Project of the Royal College of Anaesthetists // Br. J. Anaesth. 2009; 102: 179-190.
  3. Spasiano A., Flore I., Pesamosca A., Della Rocca G. Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery // Minerva Anestesiol. 2007; 73: 13-21.
  4. Casati A., Moizo E., Marchetti C., Vinciguerra F. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine or levobupivacaine for inguinal herniorrhaphy // Anesth. Analg. 2004; 99: 1387-1392.
  5. Fanelli G., Borghi B., Casati A., Bertini L., Montebugnoli M., Torri G. Unilateral bupivacaine spinal anesthesia for outpatient knee arthroscopy // Can. J. Anaesth. 2000; 47: 746-751.
  6. Casati A., Fanelli G. Restricting spinal block to the operative side: why not? // Reg. Anesth. Pain Med. 2004; 29: 4-6.
  7. Casati A., Fanelli G. Unilateral spinal anesthesia: State of the art // Minerva Anestesiol. 2001; 67: 855-862.
  8. Hansen E., Eshelman M.R., Cracchiolo A. Popliteal fossa neural blockade as the sole anesthetic technique for outpatient foot and ankle surgery // Foot Ankle Int. 2000; 21: 38-44.
  9. Borgeat A., Blumenthal S., Lambert M., Theodorou P., Vienne P. The feasibility and complications of the continuous popliteal nerve block: a 1001-case study // Anesth. Analg. 2006; 103: 229-233.
  10. Buys M.J., Arndt C.D., Vagh F., Hoard A., Gerstein N. Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injection proximal to the bifurcation // Anesth Analg. 2010; 110: 635-637.
  11. Danelli G., Fanelli A., Ghisi Dуе et al. Ultrasound vs nerve stimulation multiple injection technique for posterior popliteal sciatic nerve block // Anaesthesia. 2009; 64: 638-642.
  12. Korhonen A.M., Valanne J.V., Jokela R.M., Ravaska P., Korttila K.T. A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy // Anesth. Analg. 2004; 99: 1668-1673.
  13. Hadzic A., Vloka J.D. A comparison of the posterior versus lateral approaches to the block of the sciatic nerve in the popliteal fossa // Anesthesiology. 1998; 88: 1480-1486.
  14. Vloka J.D., Hadzic A., Lesser J.B. et al. A common epineural sheet for the nerves in the popliteal fossa and its possible implications for sciatic nerve block // Anesth. Analg. 1997; 84: 387-390.
  15. Fanelli G., Casati A., Aldegheri G. et al. Cardiovascular effects of two different regional anaesthetic techniques for unilateral leg surgery // Acta Anaesthesiol Scand. 1998; 42: 80-84.
  16. Wood J.R., White S.M. Anaesthesia for 1131 patients undergoing proximal femoral fracture repair: a retrospective, observational study of effects on blood pressure, fluid administration and perioperative anaemia // Anaesthesia. 2011; 66: 10171022.
  17. Esmaoglu A., Karaoglu S., Mizrak A., Boyaci A. Bilateral vs. unilateral spinal anesthesia for outpatient knee arthroscopies // Knee Surg Sports Traumatol Arthrosc. 2004; 12: 155-158.
  18. Vloka J.D., Hadzic A., Mulcare R. et al. Combined popliteal and posterior cutaneous nerve of the thigh blocks for short saphenous vein stripping in outpatients: an alternative to spinal anesthesia // J. Clin. Anesth. 1997; 9: 618-622.
  19. Protic A., Horvat M., Komen-Usljebrka H. et al. Benefit of the minimal invasive ultrasound-guided single shot femoropopliteal block for ankle surgery in comparison with spinal anaesthesia // Wien Klin Wochenschr. 2010; 122: 584-587.

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