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Parasacral Approach to Block the Sciatic Nerve: A 400-Case Survey
  1. Jacques Ripart, M.D., Ph.D.,
  2. Philippe Cuvillon, M.D., M.Sc.,
  3. Emmanuel Nouvellon, M.D., M.Sc.,
  4. Elisabeth Gaertner, M.D. and
  5. Jean-Jacques Eledjam, M.D., Ph.D.
  1. From the Fédération Anesthésie-Douleur-Urgence-Réanimation, Centre Hospitalier Universitaire, Nimes, France
  2. Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire, Hautepierre, Strasbourg, France
  1. Reprint requests: Jacques Ripart, M.D., Ph.D., Département d'Anesthésie-Douleur, Place du Professeur Debré, Centre Hospitalier Universitaire Caremeau, 30029 Nimes Cedex 09, France. E-mail: jacques.ripart{at}chu-nimes.fr

Abstract

Background and Objectives: Parasacral sciatic nerve block has been shown to be easy to perform, but studies reported to date involve a total of only 155 patients. The aim of this study was to assess the efficacy of parasacral sciatic nerve block in a larger group of patients.

Methods: Four hundred consecutive parasacral blocks were evaluated prospectively. The level of expertise of the practitioner, the time to perform the block, the lowest current intensity of nerve stimulation, the injected volume, the onset time, the success or failure of the block, and complications were recorded.

Results: The time required to perform the block was 7 ± 5 minutes. The lowest stimulation-current intensity was 0.4 ± 0.1 mA, and the injected volume was 27 ± 4 mL. The onset time was 13 ± 7 minutes for both motor and sensory block in all nerve distributions. The success rate was 94% (376 of 400 cases). Nine supplemental injections were performed successfully, thus increasing the success rate to 96%. General anesthesia or heavy sedation was performed in 15 cases (3.8%). There was no difference in failure rate between more experienced and less experienced anesthesiologists.

Conclusions: In this prospective 400-case study, we confirmed previous findings that the parasacral approach is effective, easy to perform, and easy to teach, even when performed by relatively inexperienced physicians. The parasacral approach is, therefore, an effective alternative to other approaches of sciatic nerve blockade.

  • Regional anesthesia
  • Local anesthetic
  • Nerve stimulation
  • Sciatic nerve block
  • Sacral plexus

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Footnotes

  • This work was supported by the Association pour la recherche en anesthésie réanimation Centre Hospitalier Universitaire de Nimes, Nimes, France.

    Presented at the 23rd annual meeting of the American Society of Regional Anesthesia, Seattle, Washington, May 14-17, 1998.

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