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Anesth Analg 2007;105:263-266
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000266437.41544.b3

ANALGESIA

Parasacral Sciatic Nerve Block: Does the Elicited Motor Response Predict the Success Rate?

Bénédicte S. Hagon, MD, Omar Itani, MD, Jawad Hosseini Bidgoli, MD, and Philippe J. Van der Linden, MD, PhD

From the Department of Anesthesiology CHU-Brugmann—Huderf, Brussels, Belgium.

Address correspondence to Hagon Bénédicte, Department of Anesthesiology, CHU-Brugmann, Place A. Van Gehuchten, 4, b-1020 Brussels. Address e-mail to benedicte.hagon{at}chu-brugmann.be.

Abstract

BACKGROUND: In this prospective, randomized, double-blind study, we compared the tibial and the peroneal evoked motor response with regard to efficacy of sciatic nerve block using the parasacral approach.

METHODS: Twenty-six ASA I–III patients scheduled for elective lower limb surgery were randomized to receive a parasacral sciatic block, using a nerve stimulator technique seeking either a tibial (n = 14) or peroneal (n = 12) motor response. After the evoked motor response was obtained, a solution of 10 mL 2% lidocaine with epinephrine and 10 mL 0.75% ropivacaine (actual final concentration of epinephrine, 1/160,000) was slowly injected through the needle. Sensory and motor blocks were assessed every 5 min for 30 min by an anesthesiologist blinded to the elicited motor response. If the block was not complete 30 min after injection of the local anesthetics, it was considered as failed, and general anesthesia was supplemented.

RESULTS: Time to perform the block and level of minimal and maximal stimulation were not different between groups. The success rate of complete block was significantly higher in the tibial compared to the peroneal group (11 of 14 vs 2 of 12; P = 0.002).

CONCLUSIONS: Eliciting a tibial motor response predicts a higher success rate than eliciting a peroneal motor response with parasacral sciatic nerve block.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.