PMID- 37145010
OWN - NLM
STAT- MEDLINE
DCOM- 20230508
LR  - 20230916
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 18
DP  - 2023 May 5
TI  - Popliteal sciatic nerve block for high-risk patients undergoing lower limb 
      angioplasty: A prospective double-blinded randomized controlled trial.
PG  - e33690
LID - 10.1097/MD.0000000000033690 [doi]
LID - e33690
AB  - BACKGROUND: To assess the rate of conversion to general anesthesia, sedative and 
      analgesic drug-sparing effects, and complications of popliteal sciatic nerve 
      block (PSNB) compared with a sham block during lower limb angioplasty. METHODS: A 
      randomized, controlled, double-blinded trial of patients with chronic 
      limb-threatening ischemia (CLTI) who receive PSNB with 0.25% levobupivacaine 
      20 mL compared with a sham block (control) during lower limb angioplasty. Pain 
      scores, conversion rate to general anesthesia, amount of sedoanalgesia drug 
      usage, complications, and satisfaction with the anesthesia technique by surgeons 
      and patients were assessed. RESULTS: Forty patients were enrolled in this study. 
      Two of 20 (10%) control group patients were converted to general anesthesia, 
      while none of the patients in the intervention group required general anesthesia 
      (P = .487). Pain scores before PSNB did not differ between the groups (P = .771). 
      After the block, pain scores in the block group were lower than those in the 
      control group: 0 (0, 1.5) (median, interquartile range) and 2.5 (0.5, 3.5), 
      respectively (P = .024). The analgesic effect persisted until immediately after 
      the surgery (P = .035). There was no difference in pain scores at the 24-hours 
      follow-up visit (P = .270). The total propofol and fentanyl dosage requirements, 
      a number of patients who required propofol and fentanyl, side effects, and 
      satisfaction were not different between the groups. No major complications were 
      noted. CONCLUSIONS: PSNB provided effective pain relief during and immediately 
      after lower limb angioplasty, but did not statistically affect the rate of 
      conversion to general anesthesia, sedoanalgesia drug usage, or complications.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Noikham, Alif
AU  - Noikham A
AUID- ORCID: 0000-0003-3644-4562
AD  - Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Tivirach, Wannapa
AU  - Tivirach W
AD  - Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Pongraweewan, Orawan
AU  - Pongraweewan O
AD  - Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Suphathamwit, Aphichat
AU  - Suphathamwit A
AD  - Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Puangpunngam, Nattawut
AU  - Puangpunngam N
AD  - Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Jirativanont, Tachawan
AU  - Jirativanont T
AD  - Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - YI7VU623SF (Propofol)
RN  - UF599785JZ (Fentanyl)
RN  - 0 (Analgesics)
SB  - IM
MH  - Humans
MH  - Pain, Postoperative/etiology/drug therapy
MH  - *Propofol/therapeutic use
MH  - Prospective Studies
MH  - *Nerve Block/methods
MH  - Sciatic Nerve
MH  - Fentanyl/therapeutic use
MH  - Lower Extremity/surgery
MH  - Analgesics/therapeutic use
MH  - Angioplasty
PMC - PMC10158915
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/05/05 12:42
MHDA- 2023/05/08 06:42
PMCR- 2023/05/05
CRDT- 2023/05/05 10:13
PHST- 2023/05/08 06:42 [medline]
PHST- 2023/05/05 12:42 [pubmed]
PHST- 2023/05/05 10:13 [entrez]
PHST- 2023/05/05 00:00 [pmc-release]
AID - 00005792-202305050-00027 [pii]
AID - 10.1097/MD.0000000000033690 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 May 5;102(18):e33690. doi: 
      10.1097/MD.0000000000033690.