• T F Tammam.
• Department of Anesthesia and Intensive Care, Suez Canal University Hospital, Port Said, Egypt. tarek1367@hotmail.com
• Acta Anaesthesiol Scand. 2013 Feb 1;57(2):243-8.

ObjectiveUltrasound guided sciatic block can be performed by different techniques. We compared namely short or long axis views of the sciatic nerve with in-plane or out-of-plane needle insertion techniques for the infragluteal sciatic nerve block (ISNB).MethodsOne hundred twenty patients with American Society of Anesthesiologists physical status I-III, scheduled for foot surgery were assigned into four groups. Group SI: patients received ultrasound-guided SNB using short axis (S) view of the SN and in-plane (I) insertion of needle. Group LI: patients received SNB using long axis (L) view of SN and (I) insertion of the needle. Group SO: patients received SNB using (S) view of SN and out-of-plane (O) insertion of the needle. Group LO: patients received SNB using (L) view of SN and (O) insertion of the needle. Primary outcomes included the time to perform the block (recognition and performance time) and the level of patient discomfort during block placement.ResultsThe recognition time and performance time were shortest in LI group (51 ± 16.4 and 87.7 ± 14.8 s), while they were longest in LO group (138.7 ± 21.4 and 160.3 ± 17.5 s). There were no significant differences between the groups as regards the number of attempts and needle redirections to elicit sciatic motor response. The level of patient discomfort was significantly less in the LI group in comparison with the SI and LO groups.ConclusionThe LI approach required less time to complete the infragluteal sciatic nerve block procedure and it was more comfortable for the patients in comparison to the SO, SI and LO approaches.© 2012 The Author. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

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