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Year : 2019  |  Volume : 63  |  Issue : 8  |  Page : 635-639

Ultrasound-guided popliteal sciatic and adductor canal block for below-knee surgeries in high-risk patients

1 Department of Anaesthesiology and Critical Care, Sapthagiri Medical College, Bengaluru, Karnataka, India
2 Department of Anaesthesiology and Critical Care, Kempegowda Institute of Medical Sciences and Research Center (KIMS), Bengaluru, Karnataka, India

Correspondence Address:
Dr. B K Arjun
Department of Anaesthesiology and Critical Care, Sapthagiri Institute of Medical Sciences and Research Center, Chikkasandra, Hesaraghatta Main Road, Bengaluru - 560 090, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ija.IJA_296_19

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Background and Aims: Central neuraxial block and general anaesthesia in patients with significant comorbidities are associated with considerable peri-operative morbidity and mortality. This study aims to delineate peripheral nerve block as a suitable alternative technique in high-risk patients posted for below-knee surgery. Methods: Twenty patients with the American Society of Anesthesiologist's (ASA) physical status grade III and IV, aged 30–80 years, scheduled for below-knee surgery from May 2018 to February 2019 were enrolled in this prospective study. All patients received ultrasound-guided popliteal sciatic block with 20 ml 0.5% ropivacaine and adductor canal block with 10 ml 0.375% ropivacaine. The peripheral nerve block success rate, sensory and motor block onset time, haemodynamic parameters, duration of post-operative analgesia and patient's satisfaction were recorded. Descriptive statistics of the study were calculated and the data was analysed using an SPSS statistics 21.0 program. Result: Surgery was performed successfully with no additional analgesic requirement in all patients. The mean duration for sensory and motor block onset time was 3.35 ± 0.49 (mean ± standard deviation) and 4.65 ± 0.48 (mean ± standard deviation) minutes respectively. Haemodynamic parameters were maintained stable throughout the procedure. The average duration of postoperative analgesia was 7.5 ± 0.8 (mean ± standard deviation) hours. Patient overall satisfaction as assessed, by three-point Lickert's scale, was satisfactory. Conclusion: Ultrasound-guided combined popliteal sciatic and adductor canal block is an effective alternative anaesthetic technique for below-knee surgeries with stability of haemodynamic parameters and pain management in high-risk patients.

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