Nasreen Laiq, Mohammad Naeem Khan, Shahid Khan, Akbar Said Jan.
Sciatic nerve block for lower limb surgery in elderly patients.
J Postgrad Med Inst Jan ;19(3):256-60.

Objective: To evaluate the effectiveness of regional anaesthesia and haemodynamic stability of sciatic nerve block for lower limb surgery in elderly patients. Material and Methods: A prospective study of fifty patients was carried out at the department of anaesthesiology of Hayatabad Medical Complex, Peshawar and Pakistan Institute of Medical Sciences Islamabad from May 2003 to April 2004. Sciatic nerve block was performed using the posterior approach of Labat. After identification of sciatic nerve, 20 ml of 0.5% bupivacaine was injected through 22 G spinal needle. Effectiveness of sciatic nerve block was assessed by degree of sympathetic, sensory and motor blockade below knee. Patients were monitored haemodynamically at five minutes interval throughout the procedure. Results: Fifty patients, 20 male and 30 female, were included in the study. Their age ranged from 50 to 70 years. Mean of onset of sympathetic block was 5 minutes while onset of complete anaesthesia i.e sensory and motor blockade was 25 minutes on average. Anaesthesia was rated as excellent in M (60%) patient, good in 15 (30%) patients and fair in 5 (10%) patients. Postoperative analgesic effect of the block remained for 16 hours. All patients remained stable haemodynamically as indicated by blood pressure, heart rate and oxygen saturation. Conclusion: Sciatic nerve block provides good anaesthesia and haemodynamic stability during lower limb surgery and prolong analgesia during postoperative period. Hence it is a good alternative for general anaesthesia.

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