Effectiveness of Peripheral Blocks Under Ultrasound Control With and Without Electrical Nerve Stimulation
Condition: Nerve Block; Efficiency; Sciatic Nerve; Ultrasonography
Study type: Interventional

Summary: 
      In modern anesthesiology, peripheral nerve blocks are performed using ultrasound control and
      electrical stimulation of peripheral nerves (PEN), or only ultrasound control or only PEN.
      The most effective methods are with the use of ultrasound control. Until now, the
      effectiveness of the sciatic nerve blockade by the subgluteal approach, performed only under
      ultrasound control without ESP, in comparison with the blockade of the sciatic nerve
      performed under ultrasound control with ESP, has not been established.

      Research hypothesis: the blockade of the sciatic nerve by the subgluteal approach performed
      only under ultrasound control has the same effectiveness as the blockade performed under the
      ultrasound control with EPN.
    


Intervention name(s): sciatic nerve blockade under ultrasound control with a peripheral nerve stimulator; sciatic nerve blockade under ultrasound control without a peripheral nerve stimulator
Intervention type(s): Other; Other
Intervention description(s): Following the ultrasound visualization of the sciatic nerve, a insulated injection needle was connected to the nerve stimulator . Under ultrasound visualization guidance, the needle of the electronic nerve stimulator was positioned at the sciatic nerve (in plane) from its lateral side at a slightly superior position . A marker for LA introduction was the visualization of the needle end near the nerve, and a positive muscular response . Subsequently, the introduction of LA solution was initiated.If LA was spreading from the lateral side down to the nerve, then the needle was replaced to the upper point of the nerve and the rest of LA was introduced, and vice versa . The presence of a complete and incomplete spread of LA along the entire circumference of the nerve was assessed. Correspondingly, if the anesthetic was spreading upwardly, the needle would be downwardly replaced.
In addition, a femoral nerve block is performed.; Under ultrasound visualization guidance, the needle owas positioned at the sciatic nerve (in plane) from its lateral side at a slightly superior position . A marker for LA introduction was the visualization of the needle end near the nerve. Subsequently, the introduction of LA solution was initiated. The position of the needle was corrected 1-2 times according to the type of anesthetic spread. If LA was spreading from the lateral side down to the nerve, then the needle was replaced to the upper point of the nerve and the rest of LA was introduced, and vice versa . The presence of a complete and incomplete spread of LA along the entire circumference of the nerve was assessed. Correspondingly, if the anesthetic was spreading upwardly, the needle would be downwardly replaced.
In addition, a femoral nerve block is performed.
Intervention MeSH terms: Iodine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Other
Keywords: sciatic nerve block; ultrasound guidance; electrical stimulation of peripheral nerves