Rationale of possibility to apply small volumes and low doses of lidocain in femoral nerve block
A. V Marochkov , V. G Piacherski , A. V Brukhnov , Z. V Kokhan
Regional Anesthesia and Acute Pain Management ›› 2014, Vol. 8 ›› Issue (3) : 33 -39.
Rationale of possibility to apply small volumes and low doses of lidocain in femoral nerve block
The goal of the study was to improve efficiency and safety of the femoral nerve blockade in patients undergoing surgery on lower extremities. Materials and Methods. The ultrasound-guided (US) femoral nerve block was performed using peripheral nerves electrical stimulator in 49 patients. The anesthesia was provided by different volumes of 0,75%, 1%, 1,5%, 2%, 3%, 4% lidocain solution. The characteristic of local anesthetic extent (complete or incomplete surrounding of femoral nerve) were evaluated on the US-device monitor during blockade. The quality of motor and sensory block was assessed within 40 minutes after block. Results. The following minimum amounts of lidocaine allow achieving complete femoral nerve blockade: 0.75% solution - 10 ml; 1% - 7.5 ml; 1.5% - 5 ml; 2% - 5 ml. Conclusion. The minimal value of local anesthetic volume and minimal lidocain amount for achieving the effective femoral nerve block was equaled to 5 ml and 75 mg correspondingly.
femoral nerve blockade / lidocaine / minimal volume of local anesthetic / ultrasound visualization
| [1] |
Рафмелл. Джеймс Р., Джозеф М. Нил, Кристофер М. Вискоуми. Регионарная анестезия: самое необходимое в анестезиологии / Пер. с англ; М.: МЕДпресс-информ, 2007. 272 с. |
| [2] |
Малрой М. Местная анестезия: Иллюстрированное практическое руководство / Пер. с англ.; М.: БИНОМ. Лаборатория знаний. 2003; 301 с. |
| [3] |
Chelly J.E. Peripherial nerve blocks. A color atlas. Third Edition. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia. 2009; 394. |
| [4] |
Marhofer P., Harrop-Griffiths W. et al. Fifteen Years of Ultrasound Guidance in Regional Anaesthesia: Part 1. British Journal of Anaesthesia. 2010; 104(5): 538-546. |
| [5] |
Geert-Jan van Geffen. The value of ultrasonography for performing peripheral nerve blocks. Theory, practice and clinical experience in adults and children. Optima Grafische Communicatie, Rotterdam. 2008; 234. |
| [6] |
Печерский В.Г., Марочков А.В. Определение минимально необходимого количества местного анестетика (лидокаина) для обеспечения эффективной и безопасной блокады седалищного нерва. Новости хирургии. 2011; 1: 77-82. |
| [7] |
Piacherski V.G., Marochkov A.V. A comparison of the onset time of complete blockade of the sciatic nerve in the application of ropivacaine and its equal volumes mixture with lidocaine: a double-blind randomized study. Korean Journal of Anesthesiology. 2013; 65(1): 42-47. |
| [8] |
Latzke D., Marhofer P., Zeitlinger M., Machata A., Neumann F., Lackner E. et al. Minimal local anaesthetic volumes for sciatic nerve block: evaluation of ED99 in volunteers. Br J Anaesth. 2010; 104: 239-244. |
| [9] |
Piacherski V.G., Marochkov A.V. Features and principles the spread of local anesthetic blockade of the sciatic nerve at depends on the amount of anesthetic. Open Journal of Anesthesiology. 2014; 4: 31-35. |
| [10] |
Brull R., Macfarlane A.J., Parrington S.J., Koshkin A., Chan V.W. Is circumferential injection advantageous for ultrasound-guided popliteal sciatic nerve block?: A proof-of-concept study. Reg Anesth Pain Med. 2011; 36(3): 266-270. |
| [11] |
Rosenberg Per. H. Maximum recommended doses of local anaesthetics - need for new recommendations? Highlights in regional anaesthesia and pain therapy. XI. Special edition World Congress on Regional Anaesthesia and Pain Therapy. Van Zunert A., Rawal N. (eds). P. 30-34. |
Eco-Vector
/
| 〈 |
|
〉 |
PDF
