Abstract

Background: Lower limb orthopedic surgeries following motorcycle accidents can be performed with spinal anesthesia, and postoperative analgesia often involves morphine along with a local anesthetic. To achieve analgesia with peripheral nerve blocks, it is necessary to block the lumbosacral plexus from L2 to S3. This study aimed to compare the use of morphine with the combined lateral femoral-sciatic block with only one puncture site.
Methods: Patients aged 18 to 60 years, after a motorcycle accident with fractures of the distal femur, knee, and proximal tibia, were included in two groups for evaluation of postoperative analgesia after surgery under spinal anesthesia. Group MO received 100 μg of morphine combined with 0.5% hyperbaric bupivacaine. Group CFS received a lateral femoral-sciatic block, with 15 ml of 0.25% levobupivacaine injected into the femoral nerve and 25 ml of the same substance injected into the sciatic nerve, accessed by neurostimulation with a 150 mm needle. The quality of analgesia, side effects, and patient satisfaction were evaluated.
Results: There was no difference between the two groups. The time to access both nerves with the neurostimulator was 3:33±0:52 minutes, ranging from 2:04 to 5:51 minutes. The average analgesia time was 18±2 hours with morphine and 21±3 hours, being highly significant. The MO group presented pruritus, nausea, vomiting, and urinary retention, which decreased the degree of patient satisfaction. All patients in the CFS group did not present any complications. Patients were followed up by telephone until the 20th postoperative day without any reported anesthetic or analgesic complications.

Keywords

Anesthetic techniques, Spinal anesthesia, Intrathecal morphine, Femoral nerve block, Sciatic nerve block, Nerve stimulator, Analgesia Postoperative