Key result
Adding fentanyl to ropivacaine fails to accelerate sensory or motor block onset in nerve blocks.
Why the study?
Peripheral nerve blocks are increasingly used for infraumblical surgeries, but the effectiveness of combined femoral and sciatic nerve block with ropivacaine alone versus with fentanyl needed evaluation.
Does adding fentanyl to ropivacaine for combined femoral and sciatic nerve block improve the onset and duration of sensory and motor blocks in patients undergoing lower limb surgeries?
RCT (n=100)
Double-blind
Randomly divided into two groups of 50 each using sealed envelopes
No
Does adding fentanyl to ropivacaine for combined femoral and sciatic nerve block improve the onset and duration of sensory and motor blocks in patients undergoing lower limb surgeries?
Absolute Event Rate: 13.14% vs 13.58%
p-value: p=0.292
The addition of fentanyl to ropivacaine for combined femoral and sciatic nerve blocks does not significantly prolong the duration of sensory or motor block compared to ropivacaine alone.
May support fentanyl adjunct in femoral-sciatic blocks; leaves open need for randomized trials before practice change.
Background: Peripheral nerve blocks are gaining popularity for many infraumblical surgeries with the development of new techniques such as ultrasound and peripheral nerve stimulator.It provides stable hemodynamic, better, and prolonged postoperative analgesia.This study was carried out to see the effectiveness of combined femoral and sciatic nerve block with ropivacaine alone and by adding fentanyl.Materials and Methods: The study was carried out on 100 patients scheduled for lower limb surgeries and were randomly divided into two groups of 50 each.In Group A, patients received 20 ml of 0.5% ropivacaine for femoral nerve block and same dose for sciatic nerve block and in Group B, 25 μg fentanyl was added each for femoral nerve and sciatic nerve block along with ropivacaine.All hemodynamic parameters, onset and duration of sensory and motor blocks were noted.The patient characteristics were analyzed using the "Chi-square tests" and the intergroup comparison of the parametric data was carried out using the unpaired t-test using software IBM SPSS 17.0.Results: Combined femoral and sciatic nerve block provide longer duration of postoperative analgesia of about 12-13 h.All the above-mentioned parameters were statistically non-significant.Conclusion: Hence in this study, onset and duration of sensory and motor block was comparable in both groups.However postoperative analgesia was prolonged as compared to neuraxial blockade without any hemodynamic instability.
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Prem Shankar Tiwari (2020) conducted an RCT in Lower limb surgeries (n=100). Ropivacaine plus fentanyl vs. 20 ml of 0.5% ropivacaine for femoral nerve block and 20 ml of 0.5% ropivacaine for sciatic nerve block was evaluated on Onset time of sensory block (minutes) (p=0.292). The addition of fentanyl to ropivacaine for combined femoral and sciatic nerve blocks did not significantly alter the onset time of sensory block (13.14 vs 13.58 minutes, p=0.292) or motor block compared to ropivacaine alone.
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