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At least 235 records · Page 13Linked to original sources

PubMed2002

A new method of continuous maxillary nerve block with an indwelling catheter.

OBJECTIVE: We describe continuous maxillary nerve block at the pterygopalatine fossa and investigate the efficacy of this technique for perioperative pain control in oral surgery. STUDY DESIGN: Sixteen patients undergoing radical maxillary sinusotomy were enrolled; group I (n = 8) received general anesthesia without maxillary nerve block, and group II (n = 8) received maxillary nerve block before general anesthesia. The intraoperative concentration of sevoflurane, the extent of blockade, and total analgesics (diclofenac sodium) needed after surgery were recorded. RESULTS: The mean sevoflurane concentration was significantly lower in group II. Diclofenac sodium consumption was significantly reduced in group II. CONCLUSION: Indwelling maxillary nerve catheter methods decrease anesthetic consumption and provide good postoperative analgesia.

Adult↗

PubMed2001

Nerve blocks versus subcutaneous infiltration for stereotactic frame placement.

In this unblinded, randomized controlled trial, we compared supraorbital and greater occipital nerve blocks with subcutaneous infiltration for anesthesia during the placement of a stereotactic head-frame. Twenty consecutive patients scheduled for functional surgery to treat Parkinson's disease were studied. Each patient received supraorbital and greater occipital nerve blocks on one side of the head and subcutaneous infiltration on the other, thereby acting as their own control. Pain was assessed by visual analog scale pain scores (scale: 0-100) for both local anesthetic injection and stereotactic pin placement. Supplementary subcutaneous infiltration was also recorded. Results are presented as mean +/- SD. Nerve blocks were significantly less painful than subcutaneous infiltration of local anesthetic at both the frontal (34 +/- 24 vs 49 +/- 25) and occipital (34 +/- 21 vs 49 +/- 23) sites. Neither technique was superior in preventing pain associated with pin placement, at either the frontal site (48 +/- 27 vs 46 +/- 24) or occipital site (33 +/- 27 vs 32 +/- 24). Supraorbital nerve blocks required significantly more supplementation than either greater occipital nerve blocks or subcutaneous infiltration. Visual analog scale pain scores were greater at local anesthetic injection and pin placement than at any subsequent time. We conclude that supraorbital and greater occipital nerve blocks are an alternative to subcutaneous infiltration for the placement of a stereotactic frame.

Administration, Cutaneous↗

PubMed2002

The anatomic relationship of the sciatic nerve to the lesser trochanter: implications for anterior sciatic nerve block.

UNLABELLED: Classic descriptions of the anterior sciatic nerve block suggest needle placement at the level of the lesser trochanter of the femur. Recently, investigators have reported that the sciatic nerve is not accessible at this level. To define more accurately the anatomic relationship of the sciatic nerve to the lesser trochanter, we analyzed magnetic resonance scans performed on 20 patients in the supine position. After IRB approval, magnetic resonance scans of the hip and proximal femur were reviewed in 20 supine patients in the neutral position. Images from five axial levels were studied, specifically, at the level of the lesser trochanter and at 1-cm intervals inferior to the lesser trochanter for 4 cm. In each axial image, the medial or lateral distance was measured from the sciatic nerve to a sagittal plane at the medial border of the femur. If the sciatic nerve was lateral to this sagittal plane (inaccessible), the distance was assigned a negative value, and if the sciatic nerve was medial to the sagittal plane (accessible), the distance was assigned a positive value. The distance between the coronal plane at the anterior border of the femur and the coronal plane through the sciatic nerve was also recorded for each level. At the level of the lesser trochanter, the sciatic nerve was lateral to the femoral border (inaccessible) in 13 of 20 patients with a mean distance of -4.0 +/- 7.7 mm. At 4 cm below the lesser trochanter, the sciatic nerve was medial to the femoral border (accessible) in 19 of 20 patients with a mean distance 7.8 +/- 5.8 mm. The distance from the anterior border of the femur to the sciatic nerve was 42.9 +/- 5.8 mm at the level of the lesser trochanter and 45.7 +/- 9.5 mm at 4 cm below the lesser trochanter. The classic description of the anterior approach to the sciatic nerve suggests that the needle be walked off medially at the level of the lesser trochanter. Our data are consistent with recent reports suggesting that in the majority of subjects, the position of the sciatic nerve relative to lesser trochanter made it inaccessible from an anterior approach at this level. In contrast, at 4 cm below the lesser trochanter, the sciatic nerve was medial to the femur in 19 of 20 subjects. We conclude that needle insertion medial to the proximal femur, 4 cm below the lesser trochanter, is a more direct anatomical approach to the anterior sciatic nerve block. IMPLICATIONS: Magnetic resonance images suggest that in the majority of supine subjects, the sciatic nerve is lateral to the lesser trochanter of the femur and therefore not accessible using the classic anterior approach. By contrast, 4 cm below the lesser trochanter, the sciatic nerve is consistently medial to the femoral shaft and therefore may be more accessible using an anterior approach.

Adult↗

PubMed2003

Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial.

STUDY OBJECTIVE: We determine whether 3-in-1 femoral nerve block is effective as analgesia for fractured neck of femur when administered by emergency physicians. METHODS: This was a prospective, randomized controlled trial with blinded assessors conducted in a district general hospital emergency department in the United Kingdom. Over a 6-month period, all patients with fractured neck of femur were considered for study. Patients were randomly assigned to receive 3-in-1 nerve block with bupivacaine plus intravenous morphine or intravenous morphine. An accreditation package for all ED medical staff was devised to ensure competence in the technique of 3-in-1 nerve block. Pain scores were recorded on arrival and at intervals up to 24 hours after admission. Morphine consumption in the first 24 hours was recorded. RESULTS: Ninety-four patients sustained fractured neck of femur during the study period; 50 were studied. Of 44 not studied, 42 were confused, 1 did not consent, and 1 was overlooked. Patients receiving 3-in-1 nerve blocks recorded a faster time to reach the lowest pain score: 2.88 hours for patients with nerve block and 5.81 hours for control patients (mean difference -2.93 h; 95% confidence interval [CI] -5.48 to -0.38 h). Nerve block recipients required significantly less morphine per hour than control patients (mean of 0.49 mg/h versus 1.17 mg/h; mean difference -0.68 mg/h; 95% CI -1.23 to -0.12 mg/h). CONCLUSION: Three-in-one femoral nerve block is an effective method of providing analgesia to patients with fractured neck of femur in the ED. All grades of medical staff were able to apply and consolidate this skill.

Aged↗

PubMed1995

A comparative evaluation of the conventional and closed-mouth technique for inferior alveolar nerve block.

The conventional inferior alveolar nerve block is sometimes ineffective for certain clinical and anatomical reasons. As a result, alternative methods have been suggested. This double-blind study compared the effectiveness of the Akinosi technique and conventional mandibular block injection techniques in 250 patients. It was concluded that the conventional or direct technique was more effective in achieving inferior alveolar nerve anaesthesia.

Adult↗

PubMed2003

Femoral-sciatic nerve blocks for complex outpatient knee surgery are associated with less postoperative pain before same-day discharge: a review of 1,200 consecutive cases from the period 1996-1999.

BACKGROUND: Outpatient knee surgery has come to involve increasingly complex procedures. The authors present observational data from a nerve block algorithm designed for the care of outpatients undergoing knee surgery. The aim of this report is to demonstrate differences in pain and unplanned hospital admission associated with surgical complexity and nerve blocks used. METHODS: Day-of-surgery outcomes were studied for 1,200 consecutive outpatients undergoing routine arthroscopy or one of six complex outpatient knee procedures. Nerve blocks were administered on the basis of anticipated pain from open incisions in the femoral and sciatic nerve distributions. Regression analysis was used to determine factors associated with postoperative pain and unplanned hospital admissions, and patients were categorized as having received femoral and sciatic nerve blocks (FSB), femoral nerve block only (FNB), or no nerve blocks. RESULTS: Patients undergoing more complex (vs. less invasive) knee surgery were at greater risk for pain (P </= 0.004), whereas the use of FSB (vs. FNB or no block) was associated with less pain (P < 0.01). When no nerve blocks were used, more complex (vs. less invasive) knee surgery was associated with a 10-fold greater risk of hospital admission (P = 0.001). In the regression analyses, more complex surgery (P < 0.001) was associated with increased risk of admission, and the use of FNB or FSB (vs. no block) was associated with a 2.5-fold reduction in unplanned admissions (P = 0.009). CONCLUSIONS: For complex knee surgery, the use of FSB was associated with less pain; the use of FNB or FSB (vs. no block) was associated with fewer hospital admissions.

Adult↗

PubMed2005

Relief of pain in acute herpes zoster by nerve blocks and possible prevention of post-herpetic neuralgia.

PURPOSE: This report describes two cases of acute herpes zoster (AHZ) treated by nerve block resulting in immediate pain relief and possible prevention of post-herpetic neuralgia (PHN). CLINICAL FEATURES: Two elderly females with AHZ of cervical dermatomes and severe pain received deep cervical and greater occipital nerve blocks with a local anesthetic, epinephrine and steroid. In both patients, pain resolved immediately and permanently (one year follow-up) after a single treatment. Case #1: A 79-yr-old female with a mechanical mitral valve and anticoagulated with warfarin presented with AHZ of 17 days duration of the right C2, 3, 4 dermatomes and severe pain. A stellate ganglion block was not performed because of anticoagulation. Rather, a deep cervical root block at C3 and a greater occipital nerve block were performed with bupivacaine, epinephrine and methylprednisolone. No adverse events were evident. Case #2: A 73-yr-old female with a history of osteoarthritis and Meniere's disease presented with AHZ of seven days duration of the left C2, 3, 4 dermatomes and severe pain. Deep cervical root blocks at C3 and C4 and a greater occipital nerve block were performed with bupivacaine, epinephrine and methylprednisolone. Side effects of dizziness, hoarseness, hypertension and Horner's syndrome resolved in a few hours. A mild sensation of itching persisted for two weeks. CONCLUSION: This report illustrates the potential of nerve blocks in severe AHZ to treat acute pain and possibly prevent PHN.

Aged↗

PubMed2001

Inclusion of lignocaine base into a polar lipid formulation--in vitro release, duration of peripheral nerve block and arterial blood concentrations in the rat.

BACKGROUND: Slow-release formulations of local anaesthetics may produce nerve blocks of long duration. The present study aimed at investigating the in vitro and in vivo properties of a polar lipid formulation for slow release of lignocaine and the effects on nerve block duration by inclusion of dexamethasone into the system. METHODS: In vitro release of lignocaine from the lipid formulation was studied in a US Pharmacopoeia rotating apparatus. Sciatic nerve blocks were induced in rats by 0.1 ml of test formulations containing lignocaine HCl 20 mg. ml-1 in aqueous solution, lignocaine base 20, 100 or 200 mg. ml-1 in lipid formulation or the last formulation with dexamethasone 0.05, 0.5 or 5 mg. ml-1. The durations of sensory and motor block and the arterial blood concentrations of lignocaine were investigated. RESULTS: In vitro there was a sustained release of lignocaine from the lipid formulation, with 50% release at around 48 h. In vivo lignocaine base 20 mg. ml-1 in lipid formulation produced sciatic nerve blocks of significantly shorter duration than lignocaine HCl 20 mg. ml-1 in aqueous solution, while lignocaine base 100 and 200 mg. ml-1 in lipid formulation produced blocks lasting two and three times longer, respectively, than the lignocaine HCl solution. Addition of dexamethasone did not affect the duration of nerve block. Following administration of lignocaine base 200 mg. ml-1 in lipid formulation, as compared to lignocaine HCl 20 mg. ml-1 in aqueous solution, the maximal blood concentration of lignocaine was only three times higher in spite of the ten-fold difference in dose, and the mean terminal half-life was three times longer, reflecting the slow release from the formulation. CONCLUSIONS: Our findings indicate that lignocaine base in polar lipids acts as a slow-release preparation of local anaesthetic both in vitro and in vivo.

Algorithms↗

PubMed2004

Can peripheral nerve blocks contribute to heel ulcers following total knee replacement?

Peripheral nerve blocks are widely used for postoperative analgesia following total knee replacement. We would like to present three cases of heel ulcers encountered following a peripheral nerve block for knee replacement surgery. Postoperative heel ulcers have resulted in delayed rehabilitation in all three patients. Attention needs to be given to the pressure points in the foot after the nerve blocks. Awareness of this uncommon complication is necessary to prevent its occurrence.

Aged↗

PubMed2002

Effect of ilioinguinal nerve block on the catecholamine plasma levels in orchidopexy: comparison with caudal epidural block.

BACKGROUND: Both caudal epidural and ilioinguinal/iliohypogastric nerve blocks have been used to provide effective intra- and postoperative analgesia. Stress response hormone levels can be used as an objective method to assess the analgesic efficacy of the anaesthetic techniques used in infraumbilical surgery in children. In this study, we compared catecholamine blood levels in children undergoing these two different supplementary analgesic/anaesthetic techniques. METHODS: Thirty male paediatric patients undergoing orchidopexy, ASA I, received inhalation general anaesthesia, and were randomly allocated to one of two groups: a caudal group (n = 15) and an ilioinguinal/iliohypogastric nerve block group (n = 15). Plasma epinephrine and norepinephrine concentrations were measured at the induction time, at the end of surgery, and in the postanaesthesia care unit. Postoperative pain score was also assessed in the postanaesthesia care unit. RESULTS: In both groups, there was a substantial decrease in the catecholamine blood levels; however, there were significantly higher levels of epinephrine in the ilioinguinal group at the end of surgery (P = 0.008) and in the recovery room (P = 0.02) and a significant higher level of norpinephrine in the recovery room (P = 0.008). CONCLUSIONS: The result of this study revealed that caudal epidural block was more effective than ilioinguinal block in suppressing the stress response as reflected in epinephrine and norepinephrine blood levels in orchidopexy patients.

Anesthesia, Caudal↗

PubMed2006

Nerve stimulator guided pudendal nerve block versus general anesthesia for hemorrhoidectomy.

PURPOSE: A randomized clinical trial was undertaken to test the hypothesis that patients receiving a nerve stimulator guided pudendal nerve block for hemorrhoidectomy would experience more effective and prolonged postoperative analgesia and shorter hospital stay compared to patients receiving general anesthesia. METHODS: This was a prospective randomized observer-blinded study. Following Ethics Committee approval and informed consent, 80 patients scheduled for hemorrhoidectomy were randomized to two groups of 40 patients each: general anesthesia alone, or nerve stimulator guided pudendal nerve block. Postoperative pain, the primary outcome variable of the study, was assessed by visual analogue scale scores at predetermined intervals during the postoperative period. Analgesic consumption, time to return to normal activities, patients' and surgeons' satisfaction, and duration of hospital stay were recorded. RESULTS: The guided pudendal nerve block group failed in three patients, requiring their conversion to general anesthesia. Otherwise, patients in the pudendal nerve block group experienced better postoperative pain relief at rest (P < 0.0001), on walking, sitting, and defecation (P < 0.001), reduced need for opioids (11/35 vs 32/37; P < 0.0001), a more rapid return to normal activities (7.2 vs 13.8 days; P < 0.0001) and also a shorter hospital stay (25/35 vs 3/37 outpatient cases; P < 0.0001) compared to the general anesthesia group. Pudendal nerve block was also associated with overall higher patient satisfaction compared to general anesthesia (30/35 vs 9/37; P < 0.0001). CONCLUSION: Nerve stimulator guided pudendal nerve block is associated with reduced postoperative pain, shortened hospital stay, and earlier return to normal activity compared to general anesthesia for hemorrhoidectomy.

Adolescent↗

PubMedDate not supplied

Percutaneous electrode guidance: a noninvasive technique for prelocation of peripheral nerves to facilitate peripheral plexus or nerve block.

BACKGROUND AND OBJECTIVES: Typically, peripheral nerve block is done by approximating nerve location, usually by use of anatomical landmarks. Precise nerve location has been done by needle exploration. A new method, percutaneous electrode guidance (PEG) of the block needle, was performed. A transcutaneous stimulating cylindrical electrode was used to indent the skin, locate the underlying nerve, and guide a block needle near it. METHODS: PEG was used to prelocate the desired nerve or neural plexus by use of a shielded cylindrical electrode with a 1-mm-diameter conductive area of skin contact at the distal end, the center of which contained a 22-gauge (1/2 mm) hole, which precisely matched a shielded conventional block needle. Transcutaneous stimulation began at less than 10 mA and was decreased to minimal amperage that elicited the desired motor response. Electrode position was fixed, and electrode current was discontinued. A shielded 22-gauge block needle was advanced through the electrode guide to near the underlying nerve. Initial needle current was only 0.5 mA. Local anesthetic was injected to block the targeted nerve or nerves. Standard sensory/motor testing was performed at 20 minutes. RESULTS: Nine upper or lower extremity blocks were performed on 7 patients. All were successful. Minimal stimulating currents were 1.3 to 8.2 mA for transcutaneous electrode stimulation and 0.20 to 0.70 for needle stimulation. Needle depth was 0.4 to 1.1 cm beyond the electrode tip and correlated with minimal electrode stimulating current. CONCLUSIONS: A smooth, metal-tipped electrically shielded skin electrode probe can be used to comfortably and accurately indent the skin over a desired nerve or plexus, define its anatomical course, and subsequently guide a block needle near it.

Adult↗

PubMed1993

Buffered versus plain lidocaine for digital nerve blocks.

STUDY OBJECTIVES: To test whether buffered lidocaine is less painful to administer as a digital nerve block than plain lidocaine. DESIGN: Randomized, double-blind, prospective clinical trial. SETTING: University hospital emergency department. PARTICIPANTS: Adults not allergic to lidocaine requiring a digital nerve block. INTERVENTIONS: Subjects received digital nerve blocks by injection of buffered lidocaine on one side and plain lidocaine on the other in a predetermined, randomized order. Pain of infiltration was assessed. Scores were compared using a two-tailed t-test. Standard 1% lidocaine was used if additional anesthetic was required. MEASUREMENTS AND MAIN RESULTS: Thirty-one patients were enrolled. Buffered lidocaine was significantly less painful to administer than plain lidocaine (P < .001; t = 4.21). Supplemental anesthesia was required less often for buffered lidocaine (two times) compared with plain lidocaine (six times), although this difference was not statistically significant. CONCLUSION: Because it causes less pain and is equally efficacious, buffered lidocaine is preferable to plain lidocaine for digital nerve blocks in adults.

Adolescent↗

PubMed1994

Transient paraplegia from intraoperative intercostal nerve block after transthoracic discectomy.

OBJECTIVE: To present two patients with transient paraplegia from intercostal nerve blocks after transthoracic discectomy. METHODS: The preoperative, intraoperative, and postoperative courses of two patients who underwent transthoracic discectomies were reviewed. A literature review of complications from thoracic disc excisions and intercostal nerve blocks also was conducted. RESULTS: Two patients experienced transient paraplegia from intercostal nerve blockade after thoracotomy for thoracic discectomies. Although transient paraplegia (or regional anesthesia) after intercostal nerve blocks has been reported and is consistent with the clinical course seen in our two patients, it has not been reported after thoracotomy for decompression of the spinal cord. CONCLUSION: Because of the inherent risk of neurologic injury after thoracic discectomy, the authors discourage the use of intercostal nerve blocks for relieving postoperative pain after transthoracic discectomy.

Aged↗

PubMed1993

Supraclavicular nerve block: anatomic analysis of a method to prevent pneumothorax.

Supraclavicular nerve blocks are technically easy to perform, but may be associated with pneumothorax. The objective of this study is to define the parasagittal anatomy important to our modified technique of supraclavicular nerve block designed to decrease the incidence of pneumothorax and to determine whether this technique is anatomically sound. Two cadaver specimens were studied. One embalmed specimen was dissected to establish the relationship of the brachial plexus to our modified needle entry site. The neck and upper thorax of an unembalmed cadaver were frozen, and parasagittal serial sections were made to establish the relationship of the brachial plexus to surface features and the chest cavity. Additionally, 12 volunteers underwent magnetic resonance (MR) imaging and anatomic measurements of their supraclavicular anatomy important to our modified block. MR imaging showed that in no instance using our modified technique was the lung contacted by the simulated needle before entering either the subclavian artery or contacting the brachial plexus. Our technique has been used in more than 110 patients without pneumothorax. The combination of our cadaver and magnetic resonance data suggests that our plumb-bob technique of supraclavicular nerve block is anatomically sound and may minimize the development of pneumothorax during supraclavicular block.

Brachial Plexus↗

PubMed1977

Local nerve block anesthesia for peroral endoscopy.

Local glossopharyngeal and superior laryngeal nerve block anesthesia for peroral endoscopy was performed on 500 patients (313 bronchoscopies, 162 esophagoscopies, 25 combined bronchoesophagoscopies). The technique allows easy insertion of rigid and flexible scopes or awake tracheal intubation of conscious patients. Glossopharyngeal nerve block causes temporary abolition of the gag reflex and loss of tactile sensation over the posterior third of the tongue and the lateral and posterior wall of the oropharynx and hypopharynx. Superior laryngeal nerve block results in loss of tactile sensation over the posterior surface of the epiglottis and the mucosa of the larynx and upper trachea. Ten of the 500 patients (2%) had an inadequate glossopharyngeal block, and 4 of the 313 patients who had a bronchoscopic examination had an inadequate superior laryngeal block. In the remaining patients, excellent anesthesia was obtained with good patient acceptance and minimal morbidity.

Anesthesia, Local↗

PubMedDate not supplied

Iliohypogastric-ilioinguinal peripheral nerve block for post-Cesarean delivery analgesia decreases morphine use but not opioid-related side effects.

PURPOSE: To examine if ilioinguinal-iliohypogastric nerve block could reduce the need for post-Cesarean delivery morphine analgesia and thus reduce the incidence of opioid related adverse-effects. METHODS: A multi-level technique for performing the nerve block with bupivacaine was developed and then utilized in this two-part study. Part one was a retrospective assessment of Cesarean delivery patients with and without ilioinguinal-iliohypogastric blocks to determine if the technique reduced patient controlled analgesia morphine use and thus would warrant further study. The second phase was a randomized double-blind placebo-controlled trial to compare post-Cesarean morphine use and the appearance of opioid-related side effects between the anesthetic and placebo-injected groups. RESULTS: Both phases demonstrated that our method of ilioinguinal-iliohypogastric nerve block significantly reduced the amount of iv morphine used by patients during the 24 hr following Cesarean delivery. In the retrospective assessment, morphine use was 49 +/- 30 mg in the block group vs 79 +/- 25 mg in the no block group (P = 0.0063). For the prospective trial, patients who received nerve blocks with bupivacaine had a similar result, self-administering 48 +/- 27 mg of morphine over 24 hr compared to 67 +/- 28 mg administered by patients who received infiltrations of saline. However, despite the significant decrease in morphine use, there was no reduction in opioid-related adverse effects: the incidences of nausea were 41% and 46% (P = 0.70) and for itching were 79% and 63% (P = 0.25) in the placebo and nerve block groups, respectively. CONCLUSION: A multi-level ilioinguinal-iliohypogastric nerve block technique can reduce the amount of systemic morphine required to control post-Cesarean delivery pain but this reduction was not associated with a reduction of opioid related adverse effects in our study group.

Adult↗

PubMed2002

A double-blinded, randomized comparison of either 0.5% levobupivacaine or 0.5% ropivacaine for sciatic nerve block.

UNLABELLED: To compare intraoperative and postoperative clinical properties of levobupivacaine and ropivacaine for sciatic nerve block, 50 ASA physical status I and II patients undergoing hallux valgus repair received a femoral nerve block with 15 mL of 2% mepivacaine. They were then randomly allocated in a double-blinded fashion to receive a sciatic nerve block with either 0.5% levobupivacaine (n = 25) or 0.5% ropivacaine (n = 25). An independent blinded observer evaluated the onset time of surgical anesthesia as well as the quality of the surgical block and postoperative analgesia. The median (range) onset time of surgical block at the sciatic nerve distribution was 30 min (5-60 min) with levobupivacaine and 15 min (5-60 min) with ropivacaine (P = 0.63). Four patients (two patients in each group) received a supplementary ankle block by the surgeon just before the beginning of surgery. All four patients also received IV fentanyl supplementation, but in three of them, propofol infusion was required to complete surgery (two in the Levobupivacaine group [8%] and one in the Ropivacaine group [4%]; P = 0.99). In six patients of the Levobupivacaine group (24%) and five patients of the Ropivacaine group (20%), IV fentanyl supplementation was required to complete surgery (P = 0.99). No differences in the time to recovery of sensory and motor function were observed between the two groups, whereas median (range) duration of postoperative analgesia was 16 h (8-24 h) with levobupivacaine and 16 h (8-24 h) with ropivacaine (P = 0.83). We conclude that 0.5% levobupivacaine and 0.5% ropivacaine provide comparable surgical anesthesia and postoperative analgesia. IMPLICATIONS: No studies have compared the clinical properties of levobupivacaine with those of ropivacaine when providing sciatic nerve block for hallux valgus repair. Results from this prospective, randomized, double-blinded study demonstrate that 20 mL of either 0.5% levobupivacaine or 0.5% ropivacaine provide comparable surgical block with prolonged postoperative analgesia.

Adult↗