Comparison of the Analgesic Duration Using Ultrasound-guided Popliteal Sciatic Nerve Block between Diabetics with Neuropathy and Nondiabetics without Neuropathy.
Ganesh Prasad, Julie C R Misquith, Karl Nicholas Sa Ribeiro, Shilpa A Naik
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Abstract
Introduction: In India, the prevalence of diabetes mellitus neuropathy was reported to be as high as 30%. Eight percentage of the diabetic population suffer from foot ulceration and 1.8% have amputations. Popliteal nerve block can be potentially used for foot and ankle surgery with several advantages.
Aim: To compare analgesic duration of an ultrasound (US)-guided popliteal sciatic nerve block between diabetics with neuropathy and nondiabetics without neuropathy.
Patients and methods: Participants were allocated into two groups for popliteal sciatic nerve blocks under US guidance. The primary outcome was the duration to onset of sensory and motor blockade. The secondary outcome was the duration to rescue analgesic and the visual analog scale scoring within 24 h. Hemodynamic outcomes were also monitored along with the above variables.
Results: It was observed that the onset of sensory blockade was faster in participants with diabetes mellitus with peripheral neuropathy as compared to the nondiabetic participants and the duration for onset of motor blockade in dorsiflexion was faster in diabetic patients as compared to the nondiabetic patients (17.48 ± 3.21 min). However, there was no significant changes when comparing the onset of duration to loss of plantar flexion, in diabetics (17.86 ± 2.29 min) versus in nondiabetics (18.51 ± 3.32 min). The duration for rescue analgesics was found to be longer in diabetic participants (13.19 ± 2.14 h) as compared to the nondiabetic participants (11.44 ± 1.86 h). No differences were observed in the hemodynamic changes and the complications associated with local anesthetics in either group.
Conclusion: Diabetic patients with neuropathy have faster onset of blockade when compared to nondiabetic patients without neuropathy which may be due to the degenerative condition of the peripheral nerves in them. The hemodynamic parameters do not play a role in defining the outcome of the block.
期刊介绍：
The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and elsewhere which have relevance to Africa. It will serve as a source of information on the state of the art of Medicine in Africa, for continuing education for doctors in Africa and other developing countries, and also for the publication of meetings and conferences. The journal will publish articles I any field of Medicine and other fields which have relevance or implications for Medicine.
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