الفهرس 
List of contents
Nerve StimulatorsOnly 14 pages are availabe for public view
 |  | from | 116 |  |  |
| | | from | 116 | | |
Abstract
Combined anterior sciatic nerve and femoral nerve block, is an effective locoregional anesthetic technique foranalgesia andanesthesiafor below knee surgery. Anterior approach of Sciatic nerve block has many advantages over the posterior or lithotomyposition as the block can be performed in the supine position, the limb needs not to be flexedand both sciatic and femoral blocks can be placed with the patient in the same position. This study was conducted on seventy patients with age ranging from 20 to 60 years of either sex scheduled forunilateral below knee operations, at Mansoura University Hospitals and Emergency Hospital, in duration from May to October 2016. Patients were randomly divided into two equal groups, each one consisted of 35 patients according to the used technique; NS group (n=35) received femoral and anterior sciatic nerve block using nerve stimulation technique and UN group(n=35) received femoral and sciatic nerve block using ultrasound plus nerve stimulator techniques. Upon arrival in the preoperative regional block room, standard monitoring was applied and all patients administered midazolam 0.03 mg/kg IV for sedation 5 min before the procedure. During the procedure, the patients were placed in the supine position with both legs extended. The upper body is best positioned flat. The hip is abducted and slight external rotation of the thigh to facilitate transducer and needle placement. Exposure of the calf and foot were required to observe motor responses of nerve stimulator. In NS group the nerve location was performed with the aid of a nerve stimulator using an insulated stimulating needle to identify femoral and sciatic nerve and obtain the proper twitches which correspond to the nerve’s distribution. In UN group, the nerve location was performed using ultrasound probe plus nerve stimulator. Both techniques were used to identify femoral and sciatic nerve and obtain the proper visualization and twitches which correspond to the nerve’s distribution. During the procedure in both techniques, data regarding block performance time was recorded. Success of block, the onset & duration of sensory &motor blocks and VAS were recorded. Successful block was defined as complete sensory and motor block without the need for general anesthesia. In case of pain during surgery, we administered intravenous analgesia (fentanyl &/or ketamine). Postoperative pain was recorded and treated by pethidine on request. Hemodynamic parameters including Heart rate and mean arterial blood were recorded intraoperative and postoperative. Our results showed statistically significantly decrease in performance time of block in UN group than NS group. There was no statistically significance difference between UN and NS groups in onset & duration of sensory and motor block of femoral & sciatic nerve, success of block, VAS, rescue intraoperative analgesia and postoperative pethidine consumption.