Comparison of Combined Sciatic(Winnie’s) Femoral Nerve Block, and Subarachnoid Block Anesthesia for Lower Limb Surgery
Description:
After taking approval from institutional ethics committee, 60 ASA grade – I, II, III patients
will be enrolled in the study undergoing lower limb surgeries. Patients will be randomly
allocated in 2 groups of 30 patients each – Group S (spinal group) and Group B (nerve block
group). Informed consent shall be taken prior to procedure. Patients will also be told about
VAS score for pain- 0= no pain and 10= worst imaginable pain.
In the operating room, after securing 18G IV cannula, all standard monitors will be attached
(NIBP, SPO2, ECG, Temperature probe, foley’s catheterization). Patients will be premedicated
with inj. Ondansetron-4mg IV stat and inj. Midazolam- 1mg IV stat in both the groups before
starting the procedure. Group S (SAB)- patients will be preloaded with 10mg/kg Ringer
lactate. Subarachnoid block in L3-L4, L4-L5 space with 0.5% Bupivacaine (Hyperbaric)-2.5ml
will be given in lateral position with involved limb in dependent position. Patient kept in
same position for 15 minutes and then turned supine. Group B (peripheral nerve block)-
femoral 3 in 1 block in supine position(with landmark technique) will be given with 20 ml of
0.25% of Bupivacaine followed by sciatic block in Labat’s approach in lateral position with
20 ml of 0.25% Bupivacaine .
Sensory block will be evaluated using the pinprick test using 22-gauge hypodermic needle, and
it will be judged adequate if there will be a complete loss of pinprick sensation at T12 in
the spinal group, or in the femoral and sciatic nerve distribution in the sciatic-femoral
group. Onset of Motor blockade will be taken when Bromage score 4 would have been achieved.
Bromage score 1- free movement of legs and feet; 2- just able to flex knees; 3- unable to
flex knees but free movement of feet; 4- unable to move legs or feet. VAS score would be
assessed after the procedure and surgery. Patients’ vitals will be recorded before procedure,
just after the procedure and intraoperative at 5, 15 and 30 min of surgery. After completion
of surgery, hemodynamic parameters would be recorded and patient would be asked about VAS
score. After surgery, patient’s and surgeon’s satisfaction would also be evaluated as ‘Yes’
or ‘No’. Duration of analgesia will be calculated from onset of sensory blockade to 1st
requirement of analgesic (VAS score >5). Injection Diclofenac- 75mg iv infusion will be given
for treatment of pain.
Condition:
Anesthesia Local
Treatment:
Subarachnoid block
Start Date:
June 2015
Sponsor:
Government Medical College, Haldwani
For More Information:
https://clinicaltrials.gov/show/NCT02713685