Lateral approach to the sciatic nerve in the popliteal fossa

Anesthesia and Analgesia
P J Zetlaoui, Hervé Bouaziz

Abstract

We describe a modification of the sciatic nerve (SN) block in the popliteal fossa through the lateral approach. After a brief anatomic study using previously reported landmarks, we propose a new needle orientation associated with a double injection technique after identification of the tibial and the common peroneal nerve. Thirty-four patients undergoing ankle or foot surgery were enrolled in this study. With patients in the supine position, the upper edge of the patella and the groove between the posterior border of the vastus lateralis and the anterior border of the tendon of the biceps femoris were identified. The needle was directed posteriorly with a 20-30 degrees angle relative to the horizontal plane and slightly caudal. Both nerves were individually located with a nerve stimulator and blocked with a mixture of lidocaine-bupivacaine and clonidine. In all but one case, the two nerves were easily located, and no vascular puncture was evident. Effective analgesia was obtained for a minimum of 15 h (first analgesic demand). We conclude that this technique, with a modified direction of the needle and a double stimulation, provides a very high rate of success for SN blockade in the popliteal fossa. We describe a new lateral ap...Continue Reading

References

Feb 1, 1992·Anaesthesia·A W KilpatrickJ G Todd
Sep 1, 1995·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D H McLeodP M Merrick
Aug 1, 1994·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D H McLeodP M Merrick
Apr 1, 1993·Anaesthesia·D J Bihari, R W Chang

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Citations

Oct 8, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Emmanuel GuntzMaurice Sosnowski
Jun 21, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Issam TanoubiJacques Ripart
Jun 3, 1999·The Surgical Clinics of North America·P W Peng, V W Chan
Feb 5, 2003·Journal of Clinical Anesthesia·Bassam Al-Nasser
Oct 14, 2003·Regional Anesthesia and Pain Medicine·Manuel Taboada MuñizPeter G Atanassoff
Nov 25, 2003·Regional Anesthesia and Pain Medicine·Manuel TaboadaPeter G Atanassoff
Aug 12, 2004·Regional Anesthesia and Pain Medicine·Vincent MinvilleDan Benhamou
Feb 4, 2005·Regional Anesthesia and Pain Medicine·F Kayser EnnekingTerese T Horlocker
Oct 6, 2010·Regional Anesthesia and Pain Medicine·Roxana M GrasuKrishna Boddu
Jan 24, 2013·Proceedings of the National Academy of Sciences of the United States of America·Erwan Le MaîtreTomas G M Hökfelt
Jun 12, 2013·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Kenneth HegewaldByron L Hutchinson
Jul 16, 2010·Annales Françaises D'anesthèsie Et De Rèanimation·D BenhamouV Chalhoub
Dec 18, 2007·Journal of Clinical Anesthesia·Abdulkadir AtimErdal Guzeldemir
Jun 5, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·F Lacroix
Feb 27, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·T GrosJ-J Eledjam
Dec 21, 2002·Best Practice & Research. Clinical Anaesthesiology·François J Singelyn
Nov 30, 1999·Anesthesia and Analgesia·X PaqueronD Benhamou
Oct 5, 2006·Current Opinion in Anaesthesiology·F J Singelyn, X Capdevila

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