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Sahare, Kamal Kishore
- Anterior Approach of Ultrasound Guided Sciatic Nerve Block for Knee and below Knee Surgeries:A Pilot Study
Abstract Views :307 |
PDF Views:107
Authors
Affiliations
1 Arihant Hospital, Dubey Colony, Mova, Raipur, IN
1 Arihant Hospital, Dubey Colony, Mova, Raipur, IN
Source
Central Journal of ISA, Vol 1, No 1 (2017), Pagination: 21-25Abstract
Background and Aims: Sciatic nerve block with femoral nerve block besides its advantages has been used to achieve complete anaesthesia for knee and below knee surgery. The anterior approach has been the most seldom used due to absence of reliable landmarks and technical difficulty. We evaluated the clinical application of the anterior approach to Sciatic nerve block under ultrasound guidance. Methods: This pilot study was conducted in 30 patients aged 18-59 yrs of ASA I-II who underwent knee and below knee surgery. With patient supine and knee externally rotated, sciatic nerve was approached under ultrasound guidance and 15 ml 0.5% bupivacaine along with 10 ml2% lignocaine with adrenaline was injected. Then 10 ml 0.5% bupivacaine&5 ml 2% lignocaine with adrenaline was injected at femoral nerve. Number of attempts, block execution time, onset of complete sensory and motor block, patient satisfaction was measured. Results: Surgical anaesthesia was achieved in 22 patients. 8 patients needed SAB wereas this was a pilot study no comparisons could be made and hence there was no p valueconsidered as failure of procedure. We observed themean number of attempts required to place the needle at site 3.50 ± 1.106; mean block execution time 9.66 ± 3.63 min; mean onset time of sensory block&motor block was 17.83 ± 7.552 min&24.97 ± 3.479 min respectively. 12 (40%) patients were satisfied with the technique used and reported it as excellent. Conclusion: Results of this study show promising outcome in terms of the number of attempts, block execution time, onset of sensory&motor block and patient satisfaction and indicate the need to conduct this study on a larger scale. We conclude that anterior approach is an excellent alternative approach to other approaches for sciatic nerve block especially in patients with multiple injuries.Keywords
Anterior Approach, Pilot Study, Sciatic Nerve Anatomy, Various Approaches for Block.Full Text
References
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- The Effect of Low-Flow and High-Flow Sevoflurane Anaesthesia on Renal and Liver Function:A Comparative Study
Abstract Views :248 |
PDF Views:95
Authors
Affiliations
1 Department of Anaesthesia & Critical Care, Pt. JNM Medical College, Raipur, IN
2 Department of Anaesthesia & Critical Care Pt. JNM Medical College, Raipur, IN
1 Department of Anaesthesia & Critical Care, Pt. JNM Medical College, Raipur, IN
2 Department of Anaesthesia & Critical Care Pt. JNM Medical College, Raipur, IN
Source
Central Journal of ISA, Vol 1, No 1 (2017), Pagination: 26-30Abstract
Background and Aims: Sevoflurane degradation products can affect liver and renal functions. The study was undertaken to assess the safety of low- flow sevoflurane anaesthesia and high- flow sevoflurane anaesthesia by comparing their effects on renal and liver functions. Material and Methods: The study was conducted in 100 adult patients of American Society of Anaesthesiologists physical status I or II, who underwent elective surgery under general anaesthesia. Patients were selected randomly into two groups to receive either low-flow Sevoflurane (n=50) or high-flow Sevoflurane (n=50) anaesthesia. In all these patients, preoperative renal function tests (RFT)&liver function tests (LFT) were done. RFT included blood urea, serum creatinine, creatinine clearance, urinary protein&LFT included serum bilirubin, SGOT, SGPT, ALP. The patients were induced by intravenous thiopentone [4-7 mg/kg] and succinylcholine [1-2 mg/kg] was given to facilitate tracheal intubation. Trachea was intubated with appropriate size cuffed endotracheal tube. Anaesthesia was maintained with either highflow Sevoflurane with fresh gas flow of 4.5- 7 Liters/minute or low-flow Sevoflurane with fresh gas flow of 1- 3 L/min. Blood samples were collected before operation and at 0 hour, 06 hr, 24 hr, 48 hr&72 hr postoperatively to measure Blood urea, Serum creatinine, Creatinine Clearance (CL), serum bilirubin, Serum Glutamic Oxaloacetic Transaminases (SGOT), Serum Glutamic Pyruvic Transaminases (SGPT), Alkaline phosphatase (ALP). Urine samples were collected at 24 hrs preoperatively&every 24 hrs for up to 72 hrs postoperatively to measure urine protein. Results: This study shows alterations in renal&hepatic functions in low-flow sevoflurane anaesthesia as well as high-flow sevoflurane anaesthesia. However, the alterations in renal&hepatic functions were within upper normal limit in both groups as assessed using conventional measures of hepatic&renal functions. Conclusion: We conclude that there were no statistically significant differences in the hepato-renal function by the effect of low flow and high flow sevoflurane anaesthesia and both seem to be equally safe.Keywords
High-Flow, Kidney Function, Low-Flow, Liver Function, Sevoflurane.Full Text
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