A Comparison Of Block Quality In Anterior And Posterior Approach To Sciatic Nerve Block

NCT03607292 | Completed

• 1 other identifier: Sciatic Nerve Block
• Study Type: interventional
• Target: 45
• Locations: 0 countries
• Sites: N/A

Brief Summary

Co-administration of the sciatic nerve block and femoral nerve block may provide anesthesia and analgesia in patients undergoing lower extremity surgery. Several approaches to sciatic nerve block have been described. The anterior and posterior approaches are two of the approaches used to make the sciatic nerve block. In our study, n = 20 patients for Group A and n = 25 patients for Group P were included. Then, sciatic nerve block and femoral nerve block were performed to each patient by using anterior or posterior approach randomly. After the block is performed, the sensory and motor block start and end times, the first intraoperative fentanyl requirement time and total amount of fentanyl required, the first Diclofenac sodium requirement time, and the total amount of diclofenac sodium that patients required were determined. As the groups were compared to each other; the time to start sensory block was statistically significantly lower, the first fentanyl requirement time was statistically significantly earlier and the total amount of fentanyl required was statistically significantly lower in Group P. Patient satisfaction, anesthesia quality and surgical quality were statistically significantly higher in Group P. In this study, the investigators concluded that if a patient does not have pain secondary to fracture, posterior approach to sciatic nerve block can be performed, whereas, if a patient has pain secondary to fracture, anterior approach to sciatic nerve block can be performed in order to avoid repositioning.

Conditions

Ankle Fractures

Keywords

Sciatic Nerve Blocks; Ankle surgery

Outcome Measures

Primary Outcomes (1)

• Comparison of sensorial block start time after sciatic nerve block performed with anterior and posterior approaches.

  Sensory block was assessed with a cold application every minute, and the block start time was recorded. When the patient was not receiving any stimulation with cold application on sciatic stimulation area, it was recorded as the start time of the full sciatic sensory block.

  up to 20 minutes.

Secondary Outcomes (12)

• Comparison of sensorial block end time after sciatic nerve block performed with anterior and posterior approaches.

  up to 300 minutes.

• Comparison of sensorial block start time after femoral nerve block performed with anterior and posterior approaches.

  up to 20 minutes.

• Comparison of sensorial block end time after femoral nerve block performed with anterior and posterior approaches.

  up to 160 minutes.

• Comparison of patient satisfaction

  After surgery up to 24 hours.

• Comparison of anesthesia quality in groups

  After surgery up to 24 hours.

Study Arms (2)

Group A

EXPERIMENTAL

Anterior sciatic nerve block

Procedure: Anterior sciatic nerve block

Group P

EXPERIMENTAL

Posterior sciatic nerve block

Procedure: Posterior sciatic nerve block

Interventions

Anterior sciatic nerve block PROCEDURE

A straight line along the femoral catheter was drawn between the anterior superior iliac spine and the finger palpating the pubic bone, the index finger was placed over the femoral artery pulse, a line was drawn perpendicular to the femoral fold. Over the pulse of the femoral artery, a point 4-5 cm lateral. The sciatic nerve was imaged by USG along the needle route and the needle was advanced to the nerve.

Group A

Posterior sciatic nerve block PROCEDURE

Patient was positioned laterally, with the limb to be blocked uppermost. The lower leg was straight extended and the upper extremity was bent 90° from the knee and was directed forward on the lower straight extended extremity. The patient's greater trochanter and posterior superior iliac spine were palpated and joined with a line, and a line was drawn 4 cm above the first line perpendicular to the caudal line. The USG probe was placed between the greater trochanter and the coccyx at the entry point of the needle and the needle was advanced by imaging the nerve.

Group P

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients who were between the ages of 18 to 65 and were going to be operated due to lateral and/or medial malleolus fracture.

Sponsors & Collaborators

• Bagcilar Training and Research Hospital: lead

MeSH Terms

Conditions

Ankle Fractures

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Ankle Injuries; Leg Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: A single blinded anesthesiologist performed posterior or anterior sciatic nerve block and femoral block and left the operating room 'after the nerve block was completed.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Randomize, single blind, prospective

Study Record Dates

• First Submitted: June 11, 2018
• First Posted: July 31, 2018
• Study Start: March 18, 2013
• Primary Completion: March 18, 2014
• Study Completion: December 20, 2014
• Last Updated: July 31, 2018

Record last verified: 2018-07