Comparative study of epidural block with combined femoral and sciatic nerve block, in adults for lower limb surgery, using bupivacaine with fentanyl

Abhity Gulia, Pramod Kohli, Maitree Pandey

Abstract


Background: Central neuraxial block (Subarachnoid and Epidural block) provide excellent conditions for lower limb surgeries. Recently combined femoral and sciatic nerve block for lower limb surgery has been shown to be as effective as the epidural block for intraoperative anaesthesia and postoperative analgesia with a definite advantage over epidural with respect to side effects.

Methods: 60 adult patients were randomized into two groups as per computer generated random table to receive epidural (group E) or combined femoral and sciatic nerve (group PNB) block for lower limb surgeries in adults. Data was analyzed by using SPSS-14 Statistical Software

Results: The surgical conditions were excellent in group PNB with no hemodynamics changes throughout the surgery. The duration of sensory block lasted 18.81 ± 1.78 hrs in group PNB and postoperative analgesia for 17 ± 1.87 hrs. The sensory and motor blockade lasted for 6.54 ± 0.87 hrs and 4.48 ± 1.02 hrs respectively in group E and postoperative analgesia for 5.13 ± 1.13 hrs. No nausea, vomiting, hypotension, vascular injury, numbness, tingling, pruritus, urine retention were noted in group PNB. In group E, hypotension was noted at 15, 30 and 45 min with 33.3% having nausea and 13.3% postoperative vomiting.

Conclusion: Combined femoral and sciatic nerve block is thus an effective and safe alternative for epidural block for surgery on the knee and below knee lower limb surgery.


Keywords


femoral and sciatic nerve block, epidural block, lower limb surgery, postoperative analgesia

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