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AN EVALUATION OF THE ELECTROPHYSIOLOGICAL EFFECTS OF THE ULTRASOUND-GUIDED INTRANEURAL SCIATIC NERVE BLOCK: PRELIMINARY DATA OF A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND STUDY
ESRA Academy. Cuevas Cairo I. Sep 8, 2016; 138529
Topic: Neurologic Complications
Dr. Ilmari Cuevas Cairo
Dr. Ilmari Cuevas Cairo

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Abstract
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Background and Aims:

A recent electrophysiological study demonstrated a subclinical axonal damage after ultrasound-guided popliteal nerve blocks in 100% of evaluated patients, irrespective of LA injection Extra or Intraneural1.
The aim is to evaluate the correlation between the LA volume and the axonal damage, assessed by an electrophysiological study at 5 weeks.

Methods:

After ethical committee approval and written informed consent, 23 patients undergoing an ultrasound-guided popliteal nerve block for foot surgery were enrolled. Using the up and down biased coin design2 the first patient received 15 ml ropivacaine 1% solution. The following were randomized basing on the previous response. If this was “success” (complete sensory-motor sciatic block 40' after LA injection) LA volume could decrease of 2 ml (probability b = 0.11) or remain the same (probability 1-b = 0.89). In case of failure LA volume was increased of 2 ml. The electrophysiological assessment was performed before the block (baseline) and 5 weeks later. Nerve injury was defined as a change in amplitude and conduction velocity to less than 80% of baseline data or change in latency to more than 120% of baseline data3.

Results:

Data of 23 patients were extrapolated from a larger study which primary endpoint was the minimum effective volume (MEV90) after popliteal LA intraneural injection (NCT02589041). No difference was found in anthropometric characteristics, as well as in latency and conduction velocity between the baseline and 5 weeks assessment.

 
MAPConclusions:

These preliminary results suggest a direct correlation between the employed LA volume and the potential axonal damage assessed 5 weeks after nerve block.

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