Comparative Study of Split Skin Graft Under Femoral Nerve and Lateral Cutaneous Nerve Block: Blind Verses USG Technique

Introduction: Local anaesthetic based nerve blockade of the lateral cutaneous nerve (LCN) of the thigh has been used extensively for postoperative analgesia in skin grafting. Sonographic nerve localization has been an increasingly popular technique to provide regional nerve blocks. Material and Method: A total 60 patients of ASA grade I, II and III, age between 20-50 years, undergoing skin grafting surgery of lower limb were enrolled and randomly divided into two groups of 30 patients in each (FN+LCN Blind and FN+LCN USG Guided). Onset and duration of sensory blockade, duration of post-operative analgesia, requirement of analgesics, ease of technique and complications were noted. Results: The onset of sensory block was early in USG guided group as compared to blind technique. Whereas duration of sensory block was prolonged in USG guided technique than blind. Also, postoperative analgesia prolonged in USG guided group than blind technique. In blind technique, maximum patients required analgesics as compared to patients in USG guided group. USG guided group required less duration and less no of pricks to perform block as compared blind technique. VAS from baseline was markedly reduced within both the groups at all time intervals, but fast decreased observed in USG guided procedure indicating the overall efficacy of the procedure. Conclusion: USG guided block had early onset of sensory block, prolonged duration of sensory analgesia and post operative analgesia with lesser requirement of analgesic, also improve block success rate, and decrease complications as compared to blind block for skin grafting. Thus, ultrasound-guided technique could be performed safely with better patient comfort and longer duration of analgesia than FN+LCN blind technique