Comparison of Spinal Anesthesia and Ultrasound-Guided Combined Sciatic-Femoral Block on Perioperative Anesthesia and Postoperative Analgesic Effect in Lower Limb Surgery: A Randomized Controlled Clinical Trial

Abstract

INTRODUCTION[|]The aim of this study was to compare the clinical efficacy and safety of an ultrasound-guided combined sciatic-femoral nerve block (SFNB) with spinal anesthesia (SA) in lower limb surgical procedures in terms of clinical properties, postoperative analgesia, and adverse outcomes.[¤]METHODS[|]This prospective, randomized study comprised 60 patients aged 18–65 years with an American Society of Anesthesiologists physical status of I-III scheduled for a lower limb surgical procedure. The patients were randomly divided into 2 groups to receive either SA (n=30) or an ultrasound-guided combined SFNB (n=30). The duration of the intervention, time to achieve surgical anesthesia, analgesia duration, intraoperative hemodynamic parameters, patient satisfaction, quality of the postoperative analgesia, and adverse outcomes were recorded and analyzed.[¤]RESULTS[|]The duration of the intervention, time to onset of sensorial and motor block, time to start of surgery, motor block reversal time, and time to first postoperative analgesic were significantly longer in the SFNB group (p<0.001). Significantly fewer patients required rescue analgesia in the first postoperative 24 hours compared with the SA group (p<0.001). The intraoperative hemodynamic parameters and adverse outcomes were similar in both groups.[¤]DISCUSSION AND CONCLUSION[|]SFNB is a safe and efficient alternative regional anesthesia technique to SA in lower limb surgical interventions, and particularly for high risk cases where SA is contraindicated. The prolonged duration of postoperative analgesia and reduced need for postoperative analgesic drug consumption were superior to SA in terms of postoperative pain management.[¤]

Keywords

• anesthesia
• femoral nerve; nerve block; pain; postoperative; sciatic nerve; spinal.