Ripart Jacques, Cuvillon Philippe, Nouvellon Emmanuel, Gaertner Elisabeth, Eledjam Jean-Jacques
Fédération Anesthésie-Douleur-Urgence-Réanimation, Centre Hospitalier Universitaire, Nimes, France.
Reg Anesth Pain Med. 2005 Mar-Apr;30(2):193-7. doi: 10.1016/j.rapm.2004.08.026.
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.
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.
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.
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.
已证实骶旁坐骨神经阻滞操作简便，但迄今为止报道的研究总共仅涉及155例患者。本研究的目的是评估在更大规模患者群体中骶旁坐骨神经阻滞的疗效。
前瞻性评估连续400例骶旁阻滞。记录操作者的专业水平、阻滞操作时间、神经刺激的最低电流强度、注射量、起效时间、阻滞的成功或失败以及并发症。
阻滞所需时间为7±5分钟。最低刺激电流强度为0.4±0.1 mA，注射量为27±4 mL。所有神经分布区域运动和感觉阻滞的起效时间均为13±7分钟。成功率为94%（400例中的376例）。成功进行了9次补充注射，从而使成功率提高到96%。15例（3.8%）患者接受了全身麻醉或深度镇静。经验丰富和经验不足的麻醉医生之间的失败率没有差异。
在这项前瞻性400例研究中，我们证实了先前的发现，即骶旁入路即使由相对缺乏经验的医生进行也是有效、易于操作且易于传授的。因此，骶旁入路是坐骨神经阻滞其他方法的有效替代方法。
