A Randomized Comparison Between ultrasound guided Vs ultrasound with PNS guided Sciatico-Femoral Nerve Block for Lower Limb Below Knee Surgeries

Over the past ten years, ultrasound guiding has grown in popularity and

has made it possible to do numerous peripheral nerve blocks that were previously impractical to carry out

using conventional methods. Many different forms of peripheral nerve blocks have been performed on

both adults and children in recent years using ultrasound technology [1–9]. Direct visualization of nerve

structures, real-time needle guidance to the target, and tracking of local anesthetic diffusion are all made

possible by ultrasound imaging. [10] According to certain reviews and meta-analyses, ultrasound-guided

peripheral nerve blocks may have a number of advantages, such as a higher success rate, a quicker

commencement of blocks, and perhaps better quality sensory blocks [11–16]. Sciatic nerve blocks are

frequently used in clinical practice to provide anesthesia and analgesia during lower limb surgery. Nerve

stimulation guidance is a traditional technique for sciatic nerve block [17,18] popular regional anesthesia

(RA) procedure for delivering anaesthetic or analgesia for below knee surgery is the sciatic nerve either

by itself or in conjunction with a femoral or saphenous nerve block, it is employed. We proposed that

using ultrasonography combined with PNS guidance to block both sciatic nerve branches would achieve

good quality of anaesthesia and will shorten the duration of the sciaticofemoral nerve block. The goal of

the current study was to compare the use of combined ultrasound and pr(PNS) guidance with the

ultrasound guidance alone.

9. MATERIALS AND METHODS: - 80 consenting patients fulfilling the inclusion criteria will

be considered for study. Workup will be done for all patients which included a detailed History, General

physical and systemic examination and all basic investigations will be done. Patients undergoing lower

limb surgery as per the routine procedure and requirement will undergo sciatico femoral block with either

ultrasonography or ultrasonography and peripheral nerve stimulator. GROUP U: - Will be the one who

would have received Ultrasonography guided sciatico-femoral nerve block with drug Inj. Lignocaine2%

with Adrenaline + Inj. Bupivacaine 0.5% + Inj. Dexamethasone 8 mg (total volume 40 cc) and GROUP

UP: - Will be given combined Ultrasonography and PNS guided sciatico-femoral nerve block with drug

Inj. Lignocaine2% with Adrenaline + Inj. Bupivacaine 0.5% + Inj.Dexamethasone 8 mg (total volume 40

cc). Hemodynamic monitoring will be done. All patients will be meticulously monitored intraoperatively

for -A) Haemodynamic parameters {HR ,SBP,DBP,MAP,SPO2}B) Sensory Blockage will be assessed

by pin prick test using 3-point scale C) Motor grade using modified bromage scale.