One-man below-knee analgesia in the Emergency Department with minimal equipment using the Single-operAtor Nerve block under Direct ultrasound visualisation in emergencY (‘SANDY’) technique: A Retrospective Analysis

Aim: To demonstrate the efficacy of single-person bedside Ultrasound Guided (USG) Popliteal-Sciatic Nerve Block (PSNB) using minimal equipment in the ED for the management of below-knee trauma. Materials & Methods: This single-centre retrospective analysis was done at the emergency department of a tertiary care centre in southern India from 1/12/2021 to 31/06/2022. The charts of all adult patients who received the block were reviewed and the reduction in pain score after the block, block success rate and incidence of side effects were analysed. Results: 103 patient records were reviewed during the study period. 98 males (95.1%) and 5 females (4.9%) had received the block. 87.4% of patients were road accident victims. The block was given by a single operator under ultrasound guidance with the stylet of an 18 gauge IV cannula mounted on a syringe filled with 1% lidocaine. The mean pain score before and 10 minutes after administering the block was 8.85 (SD ±0.78) and 2.06 (SD ±1.75) respectively. The block success rate was found to be 93.2%. Except for 7 failed blocks, there were no adverse events following the block. Conclusion: USG PSND in the emergency department technique is a safe, consistent and relatively long lasting anaesthetic technique in management of below-knee trauma.