Posterior proximal sciatic nerve block through Franco's midgluteal approach versus classic Labat-Winnie's approach in obese patients: a randomized clinical trial

Attia, Amany Mohamed; Nasr, Moustafa Magdy; Rizk, Adel

doi:10.21608/zumj.2022.161814.2640

Posterior proximal sciatic nerve block through Franco's midgluteal approach versus classic Labat-Winnie's approach in obese patients: a randomized clinical trial

Document Type : Original Article

Authors

¹ Assistant lecturer of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Zagazig University, Zagazig City, Sharqia Governorate, Egypt.

² Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

10.21608/zumj.2022.161814.2640

Abstract

Background: Sciatic Nerve Block (SNB) is commonly used for providing either anesthesia or analgesia for lower limb surgery.
Aim of the work: It is a comparison between electric nerve stimulation guided-posterior proximal SNB through Franco's midgluteal approach and the classic Labat-Winnie's approach in obese patients to find out the approach with the best outcome.
Patients and methods: It is randomized clinical study that involved eighty adult obese patients undergoing below knee surgery. These patients were randomly allocated into to two equal groups: Franco's midgluteal approach and classic Labat-Winnie's approach groups. In this study, technical characteristics [number of attempts to get the proper injection site and block performance time], anesthetic and analgesic characteristics [success rate, block onset, potency and duration, time to the first ask and the consumed amount of postoperative analgesia], discomfort level and the associated complications were recorded.
Results: The means of number of attempts to get the proper injection site and block performance time were significantly shorter in Franco's midgluteal approach than in classic Labat-Winnie's approach group. Anesthetic and analgesic characteristics of SNB with both approaches were comparable. Discomfort level and the incidence of hematoma formation were significantly lower in Franco's midgluteal than in classic Labat-Winnie's group.
Conclusion: Although the anesthetic and analgesic characteristics of posterior proximal SNB block with both approaches were comparable, however Franco's midgluteal approach has significantly lower number of attempts to get the proper injection site, shorter block performance time, lower discomfort level and lower rate of hematoma formation than classic Labat-Winnie's approach.

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