2009 Volume 20 Issue 1 Pages 13-17
This is the first report of an experience with ultrasound-guided femoral nerve block (UFB) in patients undergoing greater saphenous vein stripping surgery in Japan. The first step in UFB is to visualize all the anatomical structures in the inguinal area. An 8.5 MHz linear probe located between the inguinal ligament and the inguinal crease was held transverse to the femoral artery. The puncture was performed 0.5 cm distal to the probe with 23G needle, injecting 6-10 ml of 1% xylocaine. One hundred and seven consecutive patients (male: 35, female: 72, mean age: 61.4) with greater saphenous vein insufficiency were treated by stripping under UFB. Data collection included the amount of adjunct tumescent local anesthetic (TLA) solution, dose of Midazolam used as sedative during operation and incidence of palsy of quadriceps femoris muscle. Twelve patients (11%) did not need TLA (mean: 26.6ml) and 48 patients (45%) did not require sedative (mean: 1.6mg). On the other hand, the incidence of the palsy of quadriceps femoris muscle was 93% (100 patients). Results show that UFB has a high accuracy and efficacy of femoral nerve block but high incidence of quadriceps femoris muscle palsy. It is nessesary to revise the technique to reduce such a complication.
