Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anesthesia

Rationale and background: Peripheral neural blockade appears to provide effective analgesia with potentially less hypotension and cardiac morbidity than central neuraxial techniques. We compared the relative benefits of combined femoral and sciatic nerve block with epidural blockade as an anesthesia plan for unilateral infrainguinal surgeries. Results: The hemodynamic parameters; namely MABP was more stable with combined femoral-sciatic nerve block than in epidural group, with no significant difference in cardiac morbidity within the observation period (24 h). The onset of epidural block was significantly shorter. However, statistically and clinically significant more prolonged post-operative analgesia was noted with femoral-sciatic block group. There was no major difference in peri-operative complication within first 24 h, apart from significant shivering with epidural group and non-significant higher failure rate with femoral-sciatic group. Conclusion: The use of combined femoral-sciatic nerve block is superior in hemodynamic stability and prolonged post-operative analgesia to conventional epidural analgesia in patients undergoing unilateral infrainguinal surgeries. However, block onset is faster and success rate is better in epidural block

Issued also as CD