Abstract

PALACIOS, M. E. et al. Sciatic blockage at the level of the popliteal fossa: Comparison of two approaches. Rev. Soc. Esp. Dolor [online]. 2005, vol.12, n.5, pp.264-268. ISSN 1134-8046.

Objectives: To assess the benefits and drawbacks, both for the physician and for the patient, of the blockade of the sciatic nerve at the level of the popliteal fossa comparing the rear and the lateral approach. Material and methods: A prospective study was performed on 66 patients ASA I-II that were candidates for orthopedic foot surgery. Patients were randomized to two groups: group A (33 patients) in which the rear approach would be used and group B (33 patients) in which the lateral approach would be used. The local anesthetic used was mepivacaine 1.5% (20 ml). All the patients received prior medication with midazolam 2 mg, i.v. The following parameters were determined: age, weight, height, gender, difficulty for the anesthesiologist to find the anatomical references of the entrance point (high, medium, low), number of needle punctures before locating the nerve, time elapsed till the puncture to the location of the nerve, discomfort of the patient during the puncture (rated in a visual analogical scale from 0 to 10), tolerance of the patient to prone and supine position, global patient satisfaction (poor, regular, good, very good, excellent) and complications associated to the technique. Results: No significant differences were found between the two groups in terms of demographic characteristics, anatomical difficulty and global patient satisfaction. Blockade performed through the lateral approach results in a greater number of punctures, a longer procedure, greater discomfort for the patient and a higher risk of arterial puncture. Only two of the patients studied had some difficulty with the prone and supine position. Conclusions: The rear route is preferable for this procedure, although the lateral route is an alternative that has to be considered in some patients.

Keywords : Regional anesthesia; Sciatic nerve; Popliteal fossa; Rear approach; Lateral approach.

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