• DOI:10.1093/BJA/AEM092
• Corpus ID: 26322329

Ultrasonographic guidance for sciatic and femoral nerve blocks in children.

@article{Oberndorfer2007UltrasonographicGF,
  title={Ultrasonographic guidance for sciatic and femoral nerve blocks in children.},
  author={Ulrich Oberndorfer and Peter Marhofer and Adrian T B{\"o}senberg and Harald Willschke and M. Felfernig and Marion Weintraud and Stephan Kapral and Stephan C. Kettner},
  journal={British journal of anaesthesia},
  year={2007},
  volume={98 6},
  pages={
          797-801
        }
}

• U. Oberndorfer, P. Marhofer, +5 authors S. Kettner
• Published 1 June 2007
• Medicine
• British journal of anaesthesia

BACKGROUND
Recent studies have shown that ultrasound guidance for paediatric regional anaesthesia can improve the quality of upper extremity and neuraxial blocks. We therefore investigated whether ultrasound guidance for sciatic and femoral nerve blocks prolongs sensory blockade in comparison with nerve stimulator guidance in children.

METHODS
Forty-six children scheduled for surgery of one lower extremity were randomized to receive a sciatic and femoral nerve block under either ultrasound or nerve stimulator guidance. After induction of general anaesthesia, the blocks were performed using an ultrasound-guided multiple injection technique until the nerves were surrounded by levobupivacaine, or by nerve stimulator guidance using a predefined dose of 0.3 ml kg(-1) of levobupivacaine. An increase in heart rate of more than 15% of baseline during surgery defined a failed block. The duration of the block was determined from the injection of local anaesthetic to the time when the patient received the first postoperative analgesic.

RESULTS
Two blocks in the nerve stimulator group failed. There were no failures in the ultrasound group. The duration of analgesia was longer in the ultrasound group mean (sd) 508 (178) vs 335 (169) min (P < 0.05). The volume of local anaesthetic in sciatic and femoral nerve blocks was reduced with ultrasound compared with nerve stimulator guidance [0.2 (0.06) vs 0.3 ml kg(-1) (P < 0.001) and 0.15 (0.04) vs 0.3 ml kg(-1) (P < 0.001), respectively].

CONCLUSIONS
Ultrasound guidance for sciatic and femoral nerve blocks in children increased the duration of sensory blockade in comparison with nerve stimulator guidance. Prolonged sensory blockade was achieved with smaller volumes of local anaesthetic when using ultrasound guidance.