Comparison of Two Techniques of Sciatic Nerve Block With Levobupivacaine 0.5% in Orthopedic Surgery

Comparison of Two Techniques of Ultrasound-guided Sciatic Nerve Block Using Levobupivacaine 0.5% in Orthopedic Surgery at the Hospital Pablo Tobon Uribe - Clínica CES, 2013, Randomized Clinical Trial

The purpose of this study is to evaluate the latency period (timing between the injection of the local anesthetic and the onset of complete sensory nerve block) of two approaches for ultrasound-guided popliteal sciatic nerve block: One of the approaches is the injection of the anesthetic just at the site of the bifurcation of the sciatic nerve and the other one is injecting the local anesthetic at least 2 cm beyond the bifurcation of the aforementioned nerve. Our main hypothesis is that the first approach will decrease the latency period, and probably, will increase the success rate of the nerve block as well as patient satisfaction.

Compare the effectiveness of nerve blockade at the bifurcation site of the sciatic nerve versus distal (tibial and peroneal) using only levobupivacaine 0.5%. The primary outcome is the latency period of the nerve blockade; the secondary outcomes are rate of success of the procedure as well as patient satisfaction.

Inclusion Criteria:

• Patients scheduled for ankle or foot surgery at Hospital Pablo Tobón Uribe and Clínica CES.
• Physical status classification of the American Society of Anesthesiologists (ASA) 1-3.
• Age: 18-70 years.
• Weight: 40-100 kg
• Taller than 140 cm.

Exclusion Criteria:

• No patient acceptance.
• Contraindications for nerve block (coagulopathy, local anesthetics allergy, sepsis, infection at the site of puncture).
• Neuropathy or myopathy affecting the lower limb.
• Psychiatric or neurological diseases that alter the evaluation of patient.
• Arrhythmias.
• Heart failure.
• Diabetes Mellitus.
• Pregnancy.
• Language barriers.
• Anticoagulation.