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Combined Inguinal Paravascular (3-in-1) and Sciatic Nerve Blocks for Lower Limb Surgery
  1. Cemal Elmas, M.D.* and
  2. Peter G. Atanassoff, M.D.
  1. Presented at the XI Annual ESRA Congress (3rd joint ESRA-ASRA Congress), June 9-12, 1992, Brussels, Belgium.
  2. *From the Department of Anesthesiology, Hospital of Horgen, Horgen, and the Department of Anesthesiology,
  3. University Hospital of Zurich, Zurich, Switzerland.
  1. Address correspondence and reprint requests to Dr. Peter G. Atanassoff, Department of Anesthesiology, University Hospital, Rämistr. 100, 8091 Zurich, Switzerland.


Background and Objectives. The effects of increasing the maximum recommended dose of lidocaine 1% plus epinephrine from 500-650 mg in combined 3-in-1/sciatic nerve block were investigated in 45 adult patients scheduled for surgery on the lower limb. The goal of the study was to show primarily, whether pneumatic tourniquet pain could be reduced, whether toxic plasma levels of local anesthetic were reached, and whether any other clinical side effects occurred.

Results. The results indicated that the incidence of tourniquet pain was significantly reduced and, most important, that there were no noteworthy differences in venous lidocaine plasma levels between the two groups investigated.

Conclusions. There was a significant decrease in time required for complete neural blockade after administration of the 650 mg lidocaine dose, and little or no difference in the duration of postoperative analgesia.

  • Regional anesthesia
  • 3-in-1 nerve blocks
  • sciatic nerve blocks
  • lidocaine plasma levels
  • sensory blockade of lower limb nerves.

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