Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942006000300003
Brazilian Journal of Anesthesiology
Scientific Article

Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1%

Simplified posterior sciatic nerve block at mid gluteofemoral dulcus: comparison of different 1% lidocaine volumes

Neuber Martins Fonseca; Beatriz Lemos Mandim; Roberto Araújo Ruzi; Fabiana Rosa Tavares

http://dx.doi.org/10.1590/S0034-70942006000300003 Braz J Anesthesiol, vol.56, n3, p.230-238, 2006
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Resumo

JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo isquiático por via subglútea foi descrito com sucesso em estudo anterior, sendo mais uma opção entre as várias abordagens possíveis. O nervo isquiático torna-se superficial na borda inferior do músculo glúteo máximo, permitindo seu acesso com fácil localização, pouco desconforto e baixo risco de punção acidental de grandes vasos. O objetivo deste estudo foi avaliar o bloqueio do nervo isquiático por esta abordagem simplificada com diferentes volumes de lidocaína a 1%. MÉTODO: Foram estudados 40 pacientes com intervenções cirúrgicas na perna ou no pé distribuídos em dois grupos. Após monitorização, eles foram posicionados em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral, com auxílio de neuroestimulador e agulha de 5 cm eletricamente isolada, utilizando 300 mg (G1) ou 200 mg (G2) de lidocaína a 1% sem adrenalina. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e a concentração usados. O tempo de execução do bloqueio foi de 8,6 ± 5,7 min (G1) e 5,6 ± 5,7 min (G2). A latência foi de 5,98 ± 1,4 min (G1) e 6,7 ± 2,9 min (G2). A duração sensitiva e motora do bloqueio foi de 243 ± 37 min e 152 ± 30 min (G1) e 235 ± 39 min e 149 ± 59 min (G2), respectivamente. Não foram observadas diferenças estatísticas significativas entre os grupos estudados. CONCLUSÕES: Essa abordagem é eficaz e de fácil execução, podendo a dose total de anestésico ser reduzida sem comprometimento da qualidade.

Palavras-chave

ANATOMIA, ANESTESIA, Regional, ANESTÉSICOS, Local, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: Subgluteus sciatic nerve block has been successfully described in a previous study and is one more option among several possible approaches. The sciatic nerve becomes superficial at inferior gluteus maximus muscle where it is easily located and accessed with minor discomfort and low risk of accidental great vessels puncture. Our study aimed at evaluating this simplified sciatic nerve block approach with different 1% lidocaine volumes. METHODS: Participated in this study 40 patients submitted to leg or foot procedures, who were distributed in two groups. Patients were placed in the prone position after monitoring and blockade was induced at mid gluteofemoral sulcus with the aid of neurostimulator and with beveled insulated 5 cm needle, with 300 mg (G1) or 200 mg (G2) of 1% plain lidocaine. RESULTS: Used volumes and concentrations have promoted adequate anesthesia in all patients. Blockade time was 8.6 ± 5.7 min (G1) and 5.6 ± 5.7 min (G2). Onset time was 5.98 ± 1.4 min (G1) and 6.7 ± 2.9 min (G2). Sensory and motor block duration was 243 ± 37 min and 152 ± 30 min (G1), and 235 ± 39 min and 149 ± 59 min (G2), respectively. There were no statistically significant differences between groups. CONCLUSIONS: This is an effective and easy approach and total anesthetic dose may be decreased without impairing quality.

Keywords

ANATOMY, ANESTHESIA, Regional, ANESTHETICS, Local, ANESTHETIC TECHNIQUES, Regional

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