Novosti
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Year 2012 Vol. 20 No 6
ANESTHESIOLOGY-REANIMATOLOGY
A.V. MAROCHKOV
COMPARATIVE ESTIMATION OF EFFICACY OF FEMORAL NERVE REGIONAL BLOCKAGE AND “THREE IN ONE” BLOCKAGE
ME “Mogilev Regional Hospital”
The Republic of Belarus
Objectives. To estimate application efficacy, safety and possibility of the femoral nerve blockage and blockage of the branches of the lumbar plexus by the inguinal access (“three in one” blockage).
Methods. Prospective randomized study of the blockage results at the lower limbs operations has been conducted. Depending on the blockage technique two groups of patients were singled out. 40 femoral nerve blockages were done in the 1st group. 40 blockages of the branches of the lumbar plexus by the inguinal access combined with the sciatic nerve blockage with electrostimulator of the peripheral nerves were carried out in the 2nd group.
Results. The amount of lidocaine used for one blockage comprised 4,5±0,3 mg/kg (37,5±5,5 ml of 1% lidocaine solution) in the 1st group; in the 2nd group – 4,5±0,4 mg/kg (38,0±4,85 ml of 1% lidocaine solution) (ð>0,05). In the 1st group skin sensitivity in the femoral nerve projection was absent in 29 cases out of 40 and was preserved in the form of touch sensation with the blunt object at the level of the thigh middle third and higher in 11 cases. Skin sensitivity in the projection of the obturator and lateral skin nerves was preserved in the form of touch sensation with the blunt object in 14 cases.
In the 2nd group skin sensitivity in the femoral nerve projection was absent in 38 out of 40 cases, in the projection of the obturator nerve – in 34 cases and in the in the projection of the lateral nerve – in 27 cases. Skin sensitivity was preserved in 2 cases out of 40, in the projection of the obturator nerve – in 4 cases and in the projection of the lateral nerve – in 11 cases. The blockage of the lumbar plexus by the inguinal access (“three in one”) was ineffective in 2 out of 40 cases according the skin sensitivity estimation.
Conclusions. Application of a simple technical procedure at “three in one” blockage increases anesthesia efficacy and expands the boundaries of the possible operation.
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212026, Respublika Belarus, g. Mogilev, ul. B.-Biruli, d. 12, UZ «Mogilevskaya oblastnaya bolnitsa», reanimatsionno-anesteziologicheskoe otdelenie,
e-mail: marochkov@mail.ru,
Marochkov Aleksey Viktorovich
Marochkov A.V. Doctor of medical sciences, head of the anesthesiology-resuscitation department of ME “Mogilev Regional Hospital”.
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