Effectiveness of ultrasound-guided dual nerve block in the below-knee amputation

• Published in: BMC surgery 2023-08, Vol.23 (1), p.227-227, Article 227
• Main Authors: Huh, Jung Wook, Kim, Min Woo, Noh, Young Min, Seo, Han Eol, Lee, Dong Ha
• Format: Article
• Language: English
• Subjects: Amputation; Analgesia; Analgesics; Analysis; Anesthetics; Body image; Care and treatment; Control methods; Critical care; Delirium; Diabetes mellitus; Diabetic foot; Fasciitis; General anesthesia; Knee; Mental disorders; Morphine; Necrotizing fasciitis; Nerve block; Nerves; Opioids; Orthopedics; Pain; Pain management; Pain perception; Patients; Plantar ulcers; Postoperative care; Rehabilitation; Review boards; Self image; Side effects; Skin; Surgeons; Surgery; Ulcers; Ultrasonic imaging; Ultrasonography; Ultrasound; Vomiting
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-023-02138-9

Below knee amputation (BKA) is a common surgical procedure for diabetic foot ulcers and necrotizing lower limb fasciitis patients. However, it is a painful procedure and inadequate postoperative analgesia impedes rehabilitation and prolongs hospitalization. An ideal pain management regimen should provide superior analgesia while minimizing opioid consumption and improving rehabilitation. We retrospectively reviewed medical charts of 218 patients who underwent BKA for diabetic foot ulcer or necrotizing lower limb fasciitis at a single center between January 2017 and September 2020. Two groups were analyzed: patients who received dual nerve block (DNB) before surgery (Group I; n = 104), and patients who did not (Group II; n = 93). By the exclusion criteria, 21 patients were excluded. The femoral and sciatic nerves were each blocked separately under ultrasound guidance. This procedure was performed immediately before the operation. Group I patients' subjective pain scores were significantly lower than that of Group II at 6, 12, and 24 h after BKA (P