SU856447A1 - Method of blocking sciatic nerve - Google Patents

Description

(54) METHOD OF BLOCKING THE SEDAL NERVE

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The invention relates to medicine, and more specifically to methods of conduction blockade of nerves of the extremities.

The closest to the present invention is the method of blocking the sciatic nerve by inserting a needle with an anesthetic substance into the region of the sciatic nerve and a scientific research institute connecting the posterior superior iliac spine with the outer edge of the sciatic tuber l.

The disadvantages of this method are the use of very non-specific functionally mobile and variable, depending on the patient's constitutional and gender characteristics, landmarks. In addition, the needle puncture points are variable and difficult to determine, and the needle point itself depends on the position of the limb on the side of the blockade, which ultimately leads to failure.

Since the tip of the greater trochanter can be moved kranially and vice versa when the limb is moved, the point of intersection of the lines also moves and does not correspond to the projection of the sciatic nerve in this area. In addition, for injuries and diseases of the proximal

division of the hip and hip joint (tumor, osteomyelitis, etc.) use of the greater trochanter of the thigh. as a guideline for blockade, it is not possible.

The purpose of the invention is to prevent damage to the pelvic organs.

The goal is achieved

10 in that according to the proposed method of blocking the sciatic nerve, by inserting a needle with an anesthetic substance into the region of the sciatic nerve along the line connecting the posterior 15 superior iliac spine to the outer edge of the sciatic mound, the needle is inserted all the way into the ischial bone at the border of the lower and ileal the middle third of the line connecting the posterior superior ileal 20 spine with the outer margin of the sciatic tuber.

The drawing shows the point of vcol needle in the blockade of the sciatic nerve.

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The method is carried out as follows.

When the patient is positioned on the abdomen, the posterior superior iliac spine, the point and the sciatic nerve 30 are determined; the va on the side of the blockade and the outer edge

B sedalnogo mound on the same side. Between them, a green line (blue) is drawn to a straight line, which is divided into three equal parts (ac.cd, db). The boundary of the middle and lower third of the line ab (point d) will be the site of the needle pricking.

After determining the point of needle puncture (d), a needle is strictly vertically inserted into the sciatic bone at the border of the lower and middle third of the line connecting the back of the iliac spinal cord with the outer edge of the sciatic mound, then pulled down by 1.52, 0 mm and a sciatic nerve is searched by fan-shaped injections, until the patient feels paresthesia in the plantar and dorsal surfaces of the foot, after which the anesthetic is injected.

The method was tested in the clinic and applied in 20 patients with different ratology of the lower extremities.

Example. Patient Klinko N.I. 53 years old, a miner, industrial injury (history of the disease №ЗЭ).

Diagnosis - fracture-dislocation of the talus bone on the right. The operation is an open reduction of fracture-dislocation with the metal osteynthesis with the Kirschner needles of the talus.

Pain relief - blockade of the sciatic nerve on the right of the proposed method. Anesthetic - 15% solution of trimekain 20 ml with adrenaline 1: 200.000. A good anesthetic effect was obtained with full muscle relaxation.

Then, the patient is undergoing medical blockade of the sciatic nerve to eliminate the post-traumatic effect. Next, a positive nerve blockade is performed.

The proposed method of blocking the nerve nerve has a number of advantages compared with the known methods, which include more convenient and quick determination of the needle puncture point when performing the blockade, which is carried out using reliable, constant and easily determined bone anatomical landmarks: posterior ileus , the outer edge of the sciatic hill and, finally, the border of the middle and lower 1/3 lines connecting these bone landmarks.

It is important to place the needle puncture point on the border of the middle and lower 1/3 lines, since the depth of the needle puncture is limited to the sciatic bone over which the nerve lies, which eliminates damage to the pelvic organs, the projection of the sciatic nerve is always constant does not depend on the patient’s placement, and the needle injection point does not vary according to the proposed method of blockade and does not depend on the position of the limb on the side of the blockade, since the guidelines for determining the needle injection point are constant and independent of constitutional , Sex and age of the patient from bone pathology of the proximal femur and the hip joint on the side of the blockade.

All these advantages provide accurate leading of the needle to the nerve, technical simplicity of implementation, reliability and high efficiency of the proposed method.

Claims (1)

1. Harte F. Die Loka I aastesie. Stuttgart, 1920, p. 6-17.