Year 2013 Vol. 21 No 5

ANESTHESIOLOGY-REANIMATOLOGY

Z.V. KOKHAN, A.V. MAROCHKOV, A.V. BRUKHNOU, V.G. PIACHERSKI

ON THE POSSIBILITY OF IDENTIFYING THE PROPER INJECTION NEEDLE POSITION AT THE SCIATIC NERVE BLOCKADE

ME "Mogilev Regional Hospital"
The Republic of Belarus

Objectives. The determination of the possibility of creating the technology of the injection needle introduction in the paranervous space in relation to the sciatic nerve based on the measurement of interstitial pressure.
Methods. A prospective analysis of 22 blockades of the sciatic nerve performed with the measurement of interstitial pressure has been carried out. Blockade of the sciatic nerve was performed using the combination of 1% lidocaine solution (10 ml) and a 0,75% solution of ropivacaine (10 ml). The local anesthetic (20 ml) was injected with the dispenser (300 ml per hour). The interstitial pressure while moving the injection needle into the tissues and at reaching the paranervous space was measured.
Results. While evaluating the obtained data it was found out that there are no significant differences between three groups of interstitial pressure values at the injection of a mixture of local anesthetics intramuscularly (>0,05). After hitting the tip of the injection needle into the paranervous space a sharp decline of the interstitial pressure up to the value of 40 (35,45) mm Hg was observed. After nonparametric dispersive analysis, statistically significant differences between the mean pressure values in the paranervous space and pressure during intramuscular injection (p <0,05) were obtained. After verification of the injection needle tip position the introduction of the local anesthetics mixture was continued. Simultaneously with the introduction of local anesthetics the pressure monitoring in the paranervous space was conducted as well as the registration of values after each injected milliliter up to the finishing the mixture introduction in the calculated dose. Statistical analysis of the pressure values in the paranervous space revealed no significant differences between the data measured with each milliliter at the mixture titration (>0,05).
Conclusions. The identification method of paranervous space surrounded the sciatic nerve based on the interstitial pressure measurement may be used at the sciatic nerve blockade in clinical practice.

Keywords: regional anesthesia, blockade of the sciatic nerve, measurement of interstitial pressure, mixture of local anestheticss
p. 80 85 of the original issue
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Address for correspondence:
212002, Respublika Belarus', g. Mogilev, ul. B. Biruli, d. 12, UZ Mogilevskaia oblastnaia bol'nitsa, otdelenie anesteziologii i reanimatsii,
e-mail: coxann@yandex.ru,
Kokhan Zakhar Viktorovich
Information about the authors:
Kokhan Z.V. A physician anesthesiologist-resuscitator of department of anesthesiology and critical care of EPH "Mogilev Regional Hospital".
Marochkov A.V. MD, professor, a head of the department of anesthesiology and critical care of EPH "Mogilev Regional Hospita".
Brukhnou A.V. A physician anesthesiologist-resuscitator of department of anesthesiology and critical care of EPH "Mogilev Regional Hospital".
Piacherski V.G. A physician anesthesiologist-resuscitator of department of anesthesiology and critical care of EPH "Mogilev Regional Hospital".
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