This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (13) Citing Articles via Google Scholar Google Scholar Articles by Taboada, M. Articles by Atanassoff, P. G. Search for Related Content PubMed PubMed Citation Articles by Taboada, M. Articles by Atanassoff, P. G.

---

REGIONAL ANESTHESIA

The Effects of Three Different Approaches on the Onset Time of Sciatic Nerve Blocks with 0.75% Ropivacaine

Manuel Taboada, MD^*, Julián Álvarez, MD, PhD^*, Joaquín Cortés, MD, PhD^*, Jaime Rodríguez, MD, PhD^*, Susana Rabanal, MD^*, Francisco Gude, MD, Alexander Atanassoff, and Peter G. Atanassoff, MD Section Editor

*Department of Anesthesiology and Clinical Epidemiology Unit, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Department of Anesthesiology, Universidad de Santiago de Compostela, Spain; and Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut

Address correspondence and reprint requests to Manuel Taboada Muñiz, MD, Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Travesía da Choupana s/n, 15706 Santiago de Compostela, Spain. Address e-mail to manutabo{at}mixmail.com

We studied three different injection techniques of sciatic nerve block in terms of block onset time and efficacy with 0.75% ropivacaine. A total of 75 patients undergoing foot surgery were randomly allocated to receive sciatic nerve blockade by means of the classic posterior approach (group classic; n = 25), a modified subgluteus posterior approach (group subgluteus; n = 25), or a lateral popliteal approach (group popliteal; n = 25). All blocks were performed with the use of a nerve stimulator (stimulation frequency, 2 Hz; intensity, 2–0.5 mA) and 30 mL of 0.75% ropivacaine. Onset of nerve block was defined as complete loss of pinprick sensation in the sciatic nerve distribution with concomitant inability to perform plantar or dorsal flexion of the foot. In the three groups, an appropriate sciatic stimulation was elicited at <0.5 mA. The failure rate was similar in the three groups (group popliteal: 4% versus group classic: 4% versus group subgluteus: 8%). The onset of nerve block was slower in group popliteal (25 ± 5 min) compared with group classic (16 ± 4 min) and group subgluteus (17 ± 4 min; P < 0.001). There was no significant difference in the onset of nerve block between group classic and group subgluteus. No differences in the degree of pain measured at the first postoperative administration of pain medication were observed among the three groups. We conclude that the three approaches resulted in clinically acceptable anesthesia in the distribution of the sciatic nerve. The subgluteus and classic posterior approaches generated a significantly faster onset of anesthesia than the lateral popliteal approach.

IMPLICATIONS: Comparing three different approaches to the sciatic nerve with 0.75% ropivacaine, the classic and subgluteal approaches exhibited a faster onset time of sensory and motor blockade than the lateral popliteal approach.

This article has been cited by other articles:

				M. T. Muniz, J. Rodriguez, M. Bermudez, C. Valino, N. Blanco, M. Amor, P. Aguirre, A. Masid, J. Cortes, J. Alvarez, et al. Low Volume and High Concentration of Local Anesthetic Is More Efficacious than High Volume and Low Concentration in Labat's Sciatic Nerve Block: A Prospective, Randomized Comparison Anesth. Analg., December 1, 2008; 107(6): 2085 - 2088. [Abstract] [Full Text] [PDF]

				Y. Aissaoui, R. Bruyere, H. Mustapha, D. Bry, N. D. Kamili, and C. Miller A Randomized Controlled Trial of Pudendal Nerve Block for Pain Relief After Episiotomy Anesth. Analg., August 1, 2008; 107(2): 625 - 629. [Abstract] [Full Text] [PDF]

				B. S. Hagon, O. Itani, J. H. Bidgoli, and P. J. Van der Linden Parasacral Sciatic Nerve Block: Does the Elicited Motor Response Predict the Success Rate? Anesth. Analg., July 1, 2007; 105(1): 263 - 266. [Abstract] [Full Text] [PDF]

				M. Taboada, J. Rodriguez, C. Valino, J. Carceller, B. Bascuas, J. Oliveira, J. Alvarez, F. Gude, and P. G. Atanassoff What Is the Minimum Effective Volume of Local Anesthetic Required for Sciatic Nerve Blockade? A Prospective, Randomized Comparison Between a Popliteal and a Subgluteal Approach Anesth. Analg., February 1, 2006; 102(2): 593 - 597. [Abstract] [Full Text] [PDF]

				M. Taboada, J. Rodriguez, S. Del Rio, J. Lagunilla, J. Carceller, J. Alvarez, and P. G. Atanassoff Does the Site of Injection Distal to the Greater Trochanter Make a Difference in Lateral Sciatic Nerve Blockade? Anesth. Analg., October 1, 2005; 101(4): 1188 - 1191. [Abstract] [Full Text] [PDF]

				M. Taboada, P. G. Atanassoff, J. Rodriguez, J. Cortes, S. Del Rio, J. Lagunilla, F. Gude, and J. Alvarez Plantar Flexion Seems More Reliable than Dorsiflexion with Labat's Sciatic Nerve Block: A Prospective, Randomized Comparison Anesth. Analg., January 1, 2005; 100(1): 250 - 254. [Abstract] [Full Text] [PDF]