Two clinical cases of unintentionally prolonged sciatic nerve block

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This study describes two clinical cases of unexpectedly long duration of motor block after anterior sciatic nerve block. In two patients who underwent total knee replacement, the motor block reversion in the area of sciatic nerve innervation did not occur at the expected time. Ultrasound examination revealed the deposition of a local anesthetic near the sciatic nerve. In these two clinical cases, unintentionally prolonged sciatic nerve blockade was caused by combined age-related factors of reduced tissue perfusion and the vasoconstrictor properties of levobupivacaine. Subsequently, the block was successfully resolved in 36–38 h without any neurological consequences.

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About the authors

Vasiliy G. Tsvetkov

S. M. Kirov Military Medical Academy

ORCID iD: 0000-0003-4980-597X
Russian Federation, 6, st. Akademika Lebedeva, St. Petersburg, 194044

Roman E. Lakhin

S. M. Kirov Military Medical Academy

Author for correspondence.
ORCID iD: 0000-0001-6431-439X

MD, PhD, DSc, professor

Russian Federation, 6, st. Akademika Lebedeva, St. Petersburg, 194044

Anatoliy V. Stukalov

S. M. Kirov Military Medical Academy

ORCID iD: 0000-0002-3869-9043
Russian Federation, 6, st. Akademika Lebedeva, St. Petersburg, 194044


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Supplementary files

Supplementary Files
1. Fig. 1. Sciatic nerve block by anteromedial access. A – scheme of the blockade. Б – Sonogram of the blockade (Сед – sciatic nerve)

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2. Fig. 2. Ultrasound examination from the back of the thigh. A – Scan 18 hours after the blockade. Б – 26 hours after the blockade (Сед – sciatic nerve, MA – local anesthetic)

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