Saphenous nerve anaesthesia — a nerve stimulator technique

  • V. Kim Comfort
  • Scott A. Lang
  • Ray W. Yip
Anaesthetic Techniques

Abstract

Purpose

This two part study was undertaken to assess both the feasibility of identifying the saphenous nerve with a nerve stimulator and to assess the efficacy of saphenous nerve anaesthesia with electrical isolation of the nerve.

Methods

(Part 1): In Pan I we studied 25 volunteers. Each had saphenous nerve blocks performed using a nerve stimulator (NS) and loss of resistance (LOR) technique. We recorded 10 cm linear visual analogue pain scores on completion of the blocks, time to completion of the blocks, onset time, and success of the blocks. (Part II): Clinical utility of the NS technique of saphenous nerve block was investigated. We evaluated the NS technique in 21 consecutive patients having surgery below the knee.

Results

(Part I): The LOR technique successfully produced saphenous nerve anaesthesia in 18/25 (72%) volunteers and the NS technique was successful in all volunteers (25/25 — P < 0.05). The nerve stimulator approach required more time to complete (NS 13 ± 7 min vs LOR 8 ± 2 min; P < 0.05). Visual analogue pain scores differed (P < 0.05) with a median of 1.0 cm for the LOR technique and a median of 2 cm for the NS technique. (Part II): The saphenous nerve block was successful in 20/21 (95%) of the patients.

Conclusions

(Part I): The first part of the study established the feasibility of electrical identification of the saphenous nerve and demonstrated that the NS technique could be utilized to provide superior anaesthesia of the saphenous nerve when compared with a previously validated LOR technique. (Part II): The clinical utility of the NS technique of saphenous nerve block was successfully demonstrated.

Key words

Anaesthetic Techniques: regional, local Nerve: block, saphenous Surgery: orthopaedic 

Résumé

Objectif

Cette étude en deux parties visait à évaluer s’il est possible d’identifier le nerf saphène avec un stimulateur électrique et si le bloc nerveux de ce nerf réalisé de cette façon est efficace.

Méthodes

(Première partie): Celle-ci incluait 25 volontaires qui ont tous subi des blocs du nerf saphène réalisés après identification avec une stimulateur nerveux (SN) et suivant la technique de la perte de résistance (PR). Ont été enregistrés après le bloc: les scores de douleur sur une échelle visuelle analogique, le temps requis pour compléter le bloc, le temps de latence, et le succès du bloc. (Deuxième partie): L’utilité, en clinique, du bloc du nerf saphène sous SN a été étudiée chez 21 patients subissant une intervention sous te genou.

Résultats

(Première partie): La technique PR a permis de réussir l’anesthésie du nerf saphène chez 18 des 25 volontaires (72%) alors que la technique SN a réussi chez tous les volontaires (25 sur 25; P < 0,05). L’approche avec stimulateur nerveux a été plus longue à réaliser (SN 13 ±7 min vs PR 8 ±2 min; P < 0,05). Les scores sur l’échelle visuelle étaient différents (P < 0,05) avec une médiane de 1.0 cm pour la technique PR et une médiane de 2 cm pour la technique SN. (Deuxième partie): Le bloc du nerf saphène a réussi chez 20 des 21 (95%) des patients.

Conclusions

(Première partie): La faisabilité de l’identification électrique du nerf saphène a été démontrée. La technique SN peut être utilisée pour procurer une meilleure anesthésie du nerf saphène que la technique PR déjà confirmée. (Deuxième partie): L’utilité clinique de la technique SN de bloc du nerf saphène a été démontrée.

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Copyright information

© Canadian Anesthesiologists 1996

Authors and Affiliations

  • V. Kim Comfort
    • 1
  • Scott A. Lang
    • 1
  • Ray W. Yip
    • 1
  1. 1.Department of Anaesthesia, Royal University HospitalUniversity of SaskatchewanSaskatoonCanada

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