Ultrasound-Guided Sciatic Popliteal Nerve Block vs. Erector Spinae Plane Block in Endovascular Management of CLI

Critical Limb Ischemia (CLI), ESPB, Popliteal Nerve Block

popliteal nerve block, ESPB

Comparison of popliteal sciatic nerve block and erector spinae plane block (ESPB) in patients undergoing endovascular management of critical lower limb ischemia (CLI).

Nerve blocks, particularly regional anesthesia techniques, have been increasingly used in the endovascular management of critical lower limb ischemia (CLI). These techniques offer numerous advantages over general and local anesthesia. Primary Advantages of Nerve Blocks: 1. Superior Pain Control Nerve blocks, such as femoral and sciatic nerve blocks, provide effective pain relief by anesthetizing the nerve supply to the lower limb. They offer more comprehensive analgesia than local anesthesia alone, as they numb the entire area around the puncture site. 2. Enhanced Patient Comfort Nerve blocks allow patients to remain pain-free during and after the procedure. They minimize discomfort even in lengthy or complex cases. 3. Reduction in Systemic Analgesic Requirements By providing localized anesthesia, nerve blocks significantly reduce the need for systemic analgesics, particularly opioids. This is essential because CLI patients often have comorbidities that make opioid use risky. 4. Fewer Opioid-Related Side Effects Nerve blocks reduce the incidence of opioid-related side effects, including nausea, vomiting, respiratory depression, and sedation. 5. Improved Hemodynamic Stability Nerve blocks preserve autonomic nervous system function, reducing fluctuations in blood pressure and heart rate compared to general anesthesia. This is especially beneficial for CLI patients, who frequently have underlying cardiovascular disease.

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