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Posters • Peripheral Nerve Blocks 115

1. Interscalene brachial plexus block forost shoulder surgery pain relief in day-ase patients

. Sadashivaiah, S. Ghatgeniversity Hospital of North Staffordshire, Anaesthesia,toke on Trent, UK

im: To evaluate the safety and efficacy of Interscalene brachiallexus block (ISB) in providing adequate analgesia for day-casehoulder surgery.

ethods: Forty one adult day-case patients undergoing electivehoulder surgery received ISB under general anaesthesia with 30l of 0.25% levo-bupivacaine. Pain scores were noted at the time

f awakening and at discharge from the hospital using the numer-cal rating scale (NRS, 0-10). The need for intra and post operativepioids was documented. All patients were prescribed regular non-pioid analgesics and as required antiemetics. The incidence ofONV and the need for rescue antiemetics was documented. Anyelay in discharge from recovery room (PACU) was noted andeasons documented. Patient satisfaction was scored as yes/ no athe time of discharge from the hospital. Complications of ISB, ifny, were documented.

esults: The main surgical procedures were arthroscopy combinedith sub-acromial decompression, open rotator cuff repair or Ban-art repair. Mean NRS scores on awakening and at discharge fromhe hospital were 1.68 (0-10) and 0.19 (0-4) respectively. Fouratients needed rescue opioids in the PACU. One patient with aRS score of 10, was considered a block failure and prescribedorphine PCA. One patient required rescue antiemetic for nausea.one of the patients required further opioids or antiemetics fol-

owing discharge from the PACU. The discharge of three patientsas delayed from the PACU due to suboptimal pain relief. 98%atients expressed satisfaction with their pain management. Fea-ures of residual blockade such as paraesthesia (n�9), heavinessn�4) and paralysis of the blocked limb (n�2) were noted infteen patients. There was one unplanned admission, but no read-issions following discharge from the hospital.

onclusion: We found ISB to be a safe and effective technique ofnalgesia for shoulder surgery, which facilitates day-case dischargeith high levels of patient satisfaction.

18. Ultrasound-guided continuousciatic nerve block for postoperative painreatment after lower limb surgery

. Martinez Navas, R. Ortiz de la Tabla Gonzalez,. Vazquez Gutierrez, P. Gomez Reja, M. Reina Molina,. Echevarria Morenoalme University Hospital, Anaesthesiology Department,evilla, Spain

ackground and Aims: Phantom pain has a high incidence afterower limb amputations.Sciatic block guided by ultrasonography

ay be useful for catheter placement in a patient who is imposibleo observe foot movement using nervestimulation.

ethods: We performed ultrasound-guided continuous sciaticerve block in one 50 years old man,diabetic,ASA III patient afterupracondilar amputation for phantom pain relief.Sciatic nerve wascanned at subgluteal level.A 100mm,insulated needle was insertedn the cross axis of the ultrasound probe and avanced slowlyowards the sciatic nerve.Once the needle was in contact with theciatic nerve a bolus of 0.75% ropivacaine 5 ml was administeredhrough the needle.0.75% ropivacaine 15 ml was injected,observ-ng the distribution of the local anesthetic around the sciaticerve.After total volumen was injected a 20G stimulating catheteras introduced through the needle.A new bolus of 0.75% ropiva-

aine 10 ml was injected through the catheter and a 0.2% ropiva-aine PCA pump was connected to the catheter.

esults: The pain score before catheter placement was 100(0-00).Ten minutes after the local anesthetic bolus through the nee-le was 40 and ten minutes after the bolus through the catheter theain score was 30.Pain was evaluated 8, 16, 24, 36, 48 and 72 hoursfter the catheter was placed. Pain score was between 0 and 20lways.Patient refered a high satisfaction and rescue analgesia wasot demanded.The catheter was removed 72 hours after withoutomplications.

onclusions: Continuous sciatic nerve block guided by ultra-onography has been useful for high intensity phantom pain treat-ent in a patient without foot because of a supracondilar ampu-

ation.To locate the sciatic nerve using nervestimulation was veryifficult because of diabetic neuropathy and abscense of the foot.ltrasonography has provided an useful technique to locate the

ciatic nerve(1) and to allowed to place a catheter near the nerve.

eference. Karmakar MK.Br J Anaesth 2007;98(3):390-5.