Popliteal sciatic nerve block for high-risk patients undergoing lower limb angioplasty: A prospective double-blinded randomized controlled trial
Issued Date
2023-05-05
Resource Type
ISSN
00257974
eISSN
15365964
Scopus ID
2-s2.0-85159183645
Pubmed ID
37145010
Journal Title
Medicine (United States)
Volume
102
Issue
18
Rights Holder(s)
SCOPUS
Bibliographic Citation
Medicine (United States) Vol.102 No.18 (2023) , E33690
Suggested Citation
Noikham A., Tivirach W., Pongraweewan O., Suphathamwit A., Puangpunngam N., Jirativanont T. Popliteal sciatic nerve block for high-risk patients undergoing lower limb angioplasty: A prospective double-blinded randomized controlled trial. Medicine (United States) Vol.102 No.18 (2023) , E33690. doi:10.1097/MD.0000000000033690 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82773
Title
Popliteal sciatic nerve block for high-risk patients undergoing lower limb angioplasty: A prospective double-blinded randomized controlled trial
Author's Affiliation
Other Contributor(s)
Abstract
Background: To assess the rate of conversion to general anesthesia, sedative and analgesic drug-sparing effects, and complications of popliteal sciatic nerve block (PSNB) compared with a sham block during lower limb angioplasty. Methods: A randomized, controlled, double-blinded trial of patients with chronic limb-Threatening ischemia (CLTI) who receive PSNB with 0.25% levobupivacaine 20 mL compared with a sham block (control) during lower limb angioplasty. Pain scores, conversion rate to general anesthesia, amount of sedoanalgesia drug usage, complications, and satisfaction with the anesthesia technique by surgeons and patients were assessed. Results: Forty patients were enrolled in this study. Two of 20 (10%) control group patients were converted to general anesthesia, while none of the patients in the intervention group required general anesthesia (P =.487). Pain scores before PSNB did not differ between the groups (P =.771). After the block, pain scores in the block group were lower than those in the control group: 0 (0, 1.5) (median, interquartile range) and 2.5 (0.5, 3.5), respectively (P =.024). The analgesic effect persisted until immediately after the surgery (P =.035). There was no difference in pain scores at the 24-hours follow-up visit (P =.270). The total propofol and fentanyl dosage requirements, a number of patients who required propofol and fentanyl, side effects, and satisfaction were not different between the groups. No major complications were noted. Conclusions: PSNB provided effective pain relief during and immediately after lower limb angioplasty, but did not statistically affect the rate of conversion to general anesthesia, sedoanalgesia drug usage, or complications.