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Li YH, Wang T, Qian C, Chen GP, Lou WS, Gu JP. Application of Femoral Nerve Block in Treating Great Saphenous Vein Insufficiency by Endovenous Radiofrequency Ablation Combined with Punctate Stripping. Clin Appl Thromb Hemost 2023; 29:10760296231220054. [PMID: 38130118 DOI: 10.1177/10760296231220054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To evaluate the efficacy and safety of ultrasound-guided femoral nerve block (FNB) in treating great saphenous vein (GSV) insufficiency by endovenous radiofrequency ablation (EVRA) combined with punctate stripping (PS). METHODS This was a single-center, retrospective cohort study. A total of 135 patients were divided into Group A (59 patients) and Group B (76 patients). All patients received tumescent anesthesia during the operation, and group A received an additional ultrasound-guided FNB before the procedure. Intraoperative and postoperative pain score, the volume of tumescent anesthesia solution (TAS), and other indicators were compared in two groups. RESULTS Group A had a significantly lower intraoperative pain visual analog scale than group B (2.7 ± 1.2 vs 5.2 ± 1.5, P < 0.001). The volume of TAS in group A was significantly lower than that in group B (198 ± 26.6 ml vs 338 ± 34.7 ml, P < 0.001). Postoperative muscle strength of group A was significantly decreased compared with group B (54.2% vs 3.90%, P < 0.001); no patient had severe limitation of active movements in both groups, and all motor blocks recovered within 24 h. The incidence of skin ecchymosis in group A was lower than that in group B (18.6% vs 46.1%, P = 0.001). The operation duration of the two groups had no statistically significant difference. CONCLUSIONS Ultrasound-guided FNB in treating GSV insufficiency by EVRA combined with PS significantly relieved intraoperative pain and reduced the dosage of TAS and the incidence of skin ecchymosis without increasing the complications of anesthesia or any other surgical complications.
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Affiliation(s)
- Ying-Hao Li
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Tao Wang
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Cheng Qian
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Guo-Ping Chen
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wen-Sheng Lou
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jian-Ping Gu
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Comparison of tumescent versus ultrasound guided femoral and obturator nerve blocks for treatment of varicose veins by endovenous laser ablation. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2014.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Valsamis EM, Wade S, Thornhill C, Carey C, Ricketts D. A simple guide to regional anaesthesia. Br J Hosp Med (Lond) 2018; 79:211-217. [PMID: 29620988 DOI: 10.12968/hmed.2018.79.4.211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle). It also discusses the pharmacology of the agents used and common complications.
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Affiliation(s)
- E M Valsamis
- Core Surgical Trainee, Department of Trauma and Orthopaedics, Brighton and Sussex University Hospitals NHS Trust, Brighton BN2 5BE
| | - S Wade
- Specialty Registrar in Anaesthetics, Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton
| | - C Thornhill
- Medical Student, Brighton and Sussex University Hospitals NHS Trust, Brighton
| | - C Carey
- Consultant in Anaesthetics, Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton
| | - D Ricketts
- Consultant Orthopaedic Surgeon, Department of Trauma and Orthopaedics, Brighton and Sussex University Hospitals NHS Trust, Brighton
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Nwawka OK, Meyer R, Miller TT. Ultrasound-Guided Subgluteal Sciatic Nerve Perineural Injection: Report on Safety and Efficacy at a Single Institution. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2319-2324. [PMID: 28593710 DOI: 10.1002/jum.14271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To determine the safety and efficacy of ultrasound (US)-guided subgluteal sciatic nerve injections. METHODS A retrospective chart review of US-guided subgluteal sciatic nerve injections at our institution was performed. RESULTS Of 221 US-guided subgluteal sciatic nerve injections, 100% achieved technical success, with no postprocedure complications. Sixty-eight percent of patients with follow-up reported symptom relief. Most patients with no relief had suboptimal preprocedure screening. CONCLUSIONS With appropriate screening, our technique of US-guided subgluteal sciatic nerve injection is safe and effective.
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Affiliation(s)
- O Kenechi Nwawka
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Russell Meyer
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Theodore T Miller
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
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Marinetto E, Uneri A, De Silva T, Reaungamornrat S, Zbijewski W, Sisniega A, Vogt S, Kleinszig G, Pascau J, Siewerdsen JH. Integration of free-hand 3D ultrasound and mobile C-arm cone-beam CT: Feasibility and characterization for real-time guidance of needle insertion. Comput Med Imaging Graph 2017; 58:13-22. [PMID: 28414927 DOI: 10.1016/j.compmedimag.2017.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 12/16/2016] [Accepted: 03/28/2017] [Indexed: 12/27/2022]
Abstract
This work presents development of an integrated ultrasound (US)-cone-beam CT (CBCT) system for image-guided needle interventions, combining a low-cost ultrasound system (Interson VC 7.5MHz, Pleasanton, CA) with a mobile C-arm for fluoroscopy and CBCT via use of a surgical tracker. Imaging performance of the ultrasound system was characterized in terms of depth-dependent contrast-to-noise ratio (CNR) and spatial resolution. US-CBCT system was evaluated in phantom studies simulating three needle-based procedures: drug delivery, tumor ablation, and lumbar puncture. Low-cost ultrasound provided flexibility but exhibited modest CNR and spatial resolution that is likely limited to fairly superficial applications within a ∼10cm depth of view. Needle tip localization demonstrated target registration error 2.1-3.0mm using fiducial-based registration.
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Affiliation(s)
- E Marinetto
- Departmento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Biomedical Engineering, Johns Hopkins University, MD, USA
| | - A Uneri
- Department of Computer Science, Johns Hopkins University, Baltimore, USA
| | - T De Silva
- Department of Biomedical Engineering, Johns Hopkins University, MD, USA
| | - S Reaungamornrat
- Department of Computer Science, Johns Hopkins University, Baltimore, USA
| | - W Zbijewski
- Department of Biomedical Engineering, Johns Hopkins University, MD, USA
| | - A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, MD, USA
| | - S Vogt
- Siemens Healthcare XP Division, Erlangen, Germany
| | - G Kleinszig
- Siemens Healthcare XP Division, Erlangen, Germany
| | - J Pascau
- Departmento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, MD, USA; Department of Computer Science, Johns Hopkins University, Baltimore, USA.
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Sethi N, Pant D, Dutta A, Koul A, Sood J, Chugh PT. Comparison of caudal epidural block and ultrasonography-guided transversus abdominis plane block for pain relief in children undergoing lower abdominal surgery. J Clin Anesth 2016; 33:322-9. [DOI: 10.1016/j.jclinane.2016.03.067] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/29/2015] [Accepted: 03/16/2016] [Indexed: 10/21/2022]
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Öztürk T, Çevikkalp E, Nizamoglu F, Özbakkaloğlu A, Topcu İ. The Efficacy of Femoral Block and Unilateral Spinal Anaesthesia on Analgesia, Haemodynamics and Mobilization in Patients undergoing Endovenous Ablation in the Lower Extremity. Turk J Anaesthesiol Reanim 2016; 44:91-5. [PMID: 27366565 DOI: 10.5152/tjar.2015.66933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the efficacy of femoral block and unilateral spinal anaesthesia on analgesia, haemodynamics and mobilization during endovenous ablation in patients with lower extremity venous insufficiency. METHODS Forty patients of ASA physical status I and II, with ages ranging between 30 and 45 years, and who were scheduled for endovenous laser ablation for varicose veins were prospectively enrolled in this study. Patients were randomized into a unilateral spinal anaesthesia group (group HS, n=20) or a femoral block group (group F, n=20). Group HS received 7.5-10 mg of heavy bupivacaine for unilateral spinal anaesthesia, while group F received 100 mg prilocaine for femoral block with ultrasound guidance. The level of motor blockage (Bromage score), visual pain score, mean heart rate and mean arterial pressures were recorded at postoperative 0, 1, 2, 3d and 6 h, respectively. RESULTS Perioperative visual pain score values in both groups were <4. None of the groups required an additional analgesic agent. Bromage scores were significantly lower in group F than in group HS during the postoperative period (p<0.01). Motor function returned to normal in all patients at 3 h in group F and at 6 h in group HS. Postoperative mean heart rate and arterial pressure did not differ between the groups (p>0.05). CONCLUSION In patients with lower extremity venous insufficiency who were undergoing endovenous laser ablation, an ultrasound-guided femoral block provided similar analgesia with that of unilateral spinal anaesthesia. In group F, the duration of anaesthesia and mobilization time was shorter.
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Affiliation(s)
- Tülün Öztürk
- Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Eralp Çevikkalp
- Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Funda Nizamoglu
- Department of Cardiovascular Surgery, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Alper Özbakkaloğlu
- Department of Cardiovascular Surgery, Celal Bayar University School of Medicine, Manisa, Turkey
| | - İsmet Topcu
- Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, Manisa, Turkey
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Abstract
OBJECTIVE Peripheral nerves are well seen using ultrasound (US) imaging, making US an ideal modality for image-guided nerve injections. This article provides a technical guide for common upper and lower extremity peripheral nerve injections, including the median, ulnar, and radial nerves in the upper extremity and the lateral femoral cutaneous, sciatic, common peroneal, tibial, and sural nerves in the lower extremity. CONCLUSION US is an effective modality for use in common upper and lower extremity peripheral nerve injections. With correct technique, peripheral nerve injections can be performed safely and are useful for both diagnostic evaluation of and therapy for peripheral neuropathy.
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Arcila-Lotero MA, Mejía-Aguilar MA. Eficacia y seguridad del manejo intervencionista guiado por ultrasonografía en pacientes con dolor crónico: seguimiento a una cohorte. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rca.2014.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Arcila-Lotero MA, Mejía-Aguilar MA. Efficacy and safety of ultrasound-guided interventional management in chronic pain patients: Cohort follow-up. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rcae.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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11
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Rothe C, Steen-Hansen C, Madsen MH, Lundstrøm LH, Heimburger R, Jensen KE, Lange KHW. A novel suture method to place and adjust peripheral nerve catheters. Anaesthesia 2015; 70:791-6. [PMID: 25791369 PMCID: PMC5024019 DOI: 10.1111/anae.13053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2015] [Indexed: 12/03/2022]
Abstract
We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in‐plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial placement and then attempted to return them to their original positions. We used ultrasound to evaluate the initial and secondary catheter placements and the spread of injectate around the nerves. In 10 cases, we confirmed catheter position by magnetic resonance imaging. We judged 43/45 initial placements successful and 42/43 secondary placements successful by ultrasound, confirmed in 10/10 cases by magnetic resonance imaging.
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Affiliation(s)
- C Rothe
- Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital and University of Copenhagen, Copenhagen, Denmark
| | - C Steen-Hansen
- Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital and University of Copenhagen, Copenhagen, Denmark
| | - M H Madsen
- Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital and University of Copenhagen, Copenhagen, Denmark
| | - L H Lundstrøm
- Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital and University of Copenhagen, Copenhagen, Denmark
| | - R Heimburger
- Institute of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - K E Jensen
- Department of Radiology, Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark
| | - K H W Lange
- Department of Anaesthesia and Intensive Care, Nordsjaellands Hospital and University of Copenhagen, Copenhagen, Denmark
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Efficacy and safety of ultrasound-guided interventional management in chronic pain patients: Cohort follow-up☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1097/01819236-201543040-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Mian A, Chaudhry I, Huang R, Rizk E, Tubbs RS, Loukas M. Brachial plexus anesthesia: A review of the relevant anatomy, complications, and anatomical variations. Clin Anat 2013; 27:210-21. [PMID: 23959836 DOI: 10.1002/ca.22254] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 03/18/2013] [Indexed: 11/08/2022]
Abstract
The trend towards regional anesthesia began in the late 1800s when William Halsted and Richard Hall experimented with cocaine as a local anesthetic for upper and lower limb procedures. Regional anesthesia of the upper limb can be achieved by blocking the brachial plexus at varying stages along the course of the trunks, divisions, cords and terminal branches. The four most common techniques used in the clinical setting are the interscalene block, the supraclavicular block, the infraclavicular block, and the axillary block. Each approach has its own unique set of advantages and indications for use. The supraclavicular block is most effective for anesthesia of the mid-humerus and below. Infraclavicular blocks are useful for procedures requiring continuous anesthesia. Axillary blocks provide effective anesthesia distal to the elbow, and interscalene blocks are best suited for the shoulder and proximal upper limb. The two most common methods for localizing the appropriate nerves for brachial plexus blocks are nerve stimulation and ultrasound guidance. Recent literature on brachial plexus blocks has largely focused on these two techniques to determine which method has greater efficacy. Ultrasound guidance has allowed the operator to visualize the needle position within the musculature and has proven especially useful in patients with anatomical variations. The aim of this study is to provide a review of the literature on the different approaches to brachial plexus blocks, including the indications, techniques, and relevant anatomical variations associated with the nerves involved.
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Affiliation(s)
- Asma Mian
- Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada
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14
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A Scoping Review of the Evidence for Teaching Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2013; 38:471-80. [DOI: 10.1097/aap.0b013e3182a4ed7a] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Draeger RW, Messer TM. Suprascapular nerve palsy following supraclavicular block for upper extremity surgery: report of 3 cases. J Hand Surg Am 2012; 37:2576-9. [PMID: 23123059 DOI: 10.1016/j.jhsa.2012.08.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 08/24/2012] [Accepted: 08/24/2012] [Indexed: 02/02/2023]
Abstract
Regional anesthesia has become the preferred method of anesthesia for many upper extremity operations and generally results in decreased hospital stays, postoperative opioid requirement, and postoperative nausea. Complications of regional anesthesia are rarely reported in the literature, possibly because of limited anesthesiologist-patient follow-up. Three cases of suprascapular nerve palsy after ultrasound-guided supraclavicular nerve block for routine outpatient upper extremity surgery are reported. All cases occurred in men who originally presented with shoulder pain, which resolved with time, followed by weakness in the supraspinatus and infraspinatus, which improved over time but did not resolve. One case resulted in ipsilateral phrenic nerve palsy as well. A review of the literature on the subject accompanies the report of these 3 cases.
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Yilmaz S, Ceken K, Alimoglu E, Sindel T. US-guided femoral and sciatic nerve blocks for analgesia during endovenous laser ablation. Cardiovasc Intervent Radiol 2012; 36:150-7. [PMID: 22414985 DOI: 10.1007/s00270-012-0366-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 02/08/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. METHODS During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment. RESULTS After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). CONCLUSIONS Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.
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Affiliation(s)
- Saim Yilmaz
- Department of Radiology, Akdeniz University School of Medicine, 07050, Arapsuyu, Antalya, Turkey.
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The Creation of an Objective Assessment Tool for Ultrasound-Guided Regional Anesthesia Using the Delphi Method. Reg Anesth Pain Med 2012; 37:329-33. [DOI: 10.1097/aap.0b013e318246f63c] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Affiliation(s)
- Sean Flack
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA.
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