Novosti
Khirurgii

PECHERSKY V.G., MAROCHKOV A.V.

PECULIARITIES OF THE LOCAL ANESTHETIC DISTRIBUTION AT THE SCIATIC NERVE BLOCKADE

Objectives. To investigate the peculiarities of distribution of the local anesthetic solution at the sciatic nerve blockade depending on the preparation volume and anatomical constitution peculiarities.
Methods. 166 sciatic nerve blockades were analyzed which were performed under ultrasound visualization control. The blockade of the sciatic nerve was done with lidocaine in the volume of 30 ml; 25 ml; 20 ml; 15 ml; 12,5 ml; 10 ml; 7,5 ml; 6,5 ml; 5 ml; 4,5 ml. The cross-sectional area corresponding to the local anesthetic was determined; the length of anesthetic distribution along the sciatic nerve was calculated.
Results. The anesthetic is spreading along the sciatic nerve in the proximal and distal directions, forming a kind of a cylinder. Minimal volume of the local anesthetic which is able to obduce the sciatic nerve completely is 5ml. A rare variant of the sciatic nerve structure is described where one of the branches of the sacral plexus was immediately formed by the tibial and by the common peroneal nerves.
Conclusions. At the preparation volume decreasing the reducing of the length of anesthetic distribution as well as the cross-sectional area, occupied by it around the nerve can be observed. Ultrasound visualization allows taking into account anatomical peculiarities of the sciatic nerve which can influence the quality of the carried out blockade.

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