Comparison between continuous femoral-sciatic block with continuous epidural block on reduced level of high-sensitivity C-reactive protein, prostaglandin E2, interleukine-6, and visual analog scale in lower limb surgery: Randomized, pre, and post-test trials

• Published in: Bali journal of anesthesiology Vol. 7; no. 2; pp. 66 - 75
• Main Authors: Widnyana, Made, Senapathi, Tjokorda, Pradhana, Adinda
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 2023
• Subjects: Continuous epidural block; continuous femoral-sciatic block; PGE2; VAS; HsCRP; IL-6
• ISSN: 2549-2276; 2549-2276
• DOI: 10.4103/bjoa.bjoa_14_23

Introduction: Continuous femoral-sciatic block and continuous epidural block have antinociceptive and anti-inflammatory effects through Na-K channel block at the peripheral level and spinal nerve. The anti-inflammatory effect in the continuous femoral-sciatic block is better than in continuous epidural block due to the block density, which could limit neurogenic inflammation to reduce cytokine production and postoperative pain severity. Materials and Methods: This study was a clinical trial with randomized sampling in pre and post-test design. A total of 60 samples were used in this study and were divided into two groups: continuous anesthesia femoral-sciatic block and continuous anesthesia epidural block. Result: There was a decrease in the prostaglandin E2 (PGE2) level in group I, which was statistically significant than the control group (P < 0.05). However, there was an increased level of high-sensitivity C-reactive protein in both groups in which the gap was found lesser in the control group (P < 0.05). Meanwhile, the interleukin-6 (IL-6) level was only decreased on the third day postoperative in group I but was not statistically significant (P > 0.05) than the control group. Visual analog scale (VAS) score at rest was decreased on the third day postoperative, and VAS at movement in the first hour and on the third day of postoperative was much better in group I than group II in a statistically significant manner (P < 0.05). Conclusion: The continuous femoral-sciatic block could reduce the level of PGE2 than the control group and attenuate the increased level of IL-6. However, the VAS score decreased at rest and on movement and was purely the effect of the continuous femoral-sciatic block.