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  • Title: Is a double-injection technique superior to a single injection in posterior subgluteal sciatic nerve block?
    Author: Taboada M, Alvarez J, Cortés J, Rodríguez J, Atanassoff PG.
    Journal: Acta Anaesthesiol Scand; 2004 Aug; 48(7):883-7. PubMed ID: 15242434.
    Abstract:
    BACKGROUND AND OBJECTIVES: Currently, no information is available on the effects of a double-injection technique on onset time and efficacy following subgluteal sciatic nerve blockade. We hypothesized that the success rate and time to onset of subgluteal nerve block following a double-injection technique would be superior to that after a single injection. METHODS: Fifty ASA I or II patients undergoing foot or ankle surgery randomly received a single or double injection subgluteal sciatic nerve block. Group S (n=25) received a single injection of 30 ml of 0.75% ropivacaine to the sciatic nerve. In Group D (n = 25), 15 ml of the same solution was injected to each sciatic nerve component. Completion of sensory and motor blockade, and patient acceptance, was evaluated by a blinded anesthesiologist. RESULTS: Complete sensory and motor blockade of the foot was achieved faster with the double injection (7.4 [5.9-8.8] min and 12.3 [10.4-14.2] min, respectively) than with the single-injection technique (12.5 [10.7-14.3] min and 18.8 [16.7-21.0] min, respectively) (P<0.001 and P<0.001, respectively). Success rate and acceptance were similar in both groups. Severe or moderate discomfort during the procedure was less frequent after a single injection (P = 0.013). CONCLUSIONS: Both the single- and double-injection technique for subgluteal sciatic nerve blockade resulted in acceptable anesthesia in most patients. The double injection generated a faster onset of anesthesia than the single injection. However, the double-injection technique caused more patient discomfort during establishment of the nerve block.
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