Abstract
The popliteal sciatic nerve block is a well-established and popular technique of peripheral nerve blockade in the lower limb. It is a versatile block in that it may be performed in varying patient positions (prone, lateral, or supine), using different approaches (lateral-to-medial, posterior-to-anterior). The landmark-guided technique uses neurostimulation to locate the nerves and is both effective and easy to perform. The advent of ultrasound imaging though has both revolutionized our approach to the popliteal sciatic nerve block and enhanced our understanding of neural anatomy. In particular, the concept of a paraneural sheath in this region is now well-accepted and has changed the way we think about “intraneural” and “extraneural” injections.
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Andersen HL, Andersen SL, Tranum-Jensen J. Injection inside the paraneural sheath of the sciatic nerve: direct comparison among ultrasound imaging, macroscopic anatomy, and histologic analysis. Reg Anesth Pain Med. 2012;37:410–4.
Edward Kim T, Howard SK, Funck N, Kyle Harrison T, Walters TL, Wagner MJ, Ganaway T, Mullens J, Lehnert B, Mariano ER. A randomized comparison of long-axis and short-axis imaging for in-plane ultrasound-guided popliteal-sciatic perineural catheter insertion. J Anesth. 2014; https://doi.org/10.1007/s00540-014-1832-8.
Franco CD. Connective tissues associated with peripheral nerves. Reg Anesth Pain Med. 2012;37:363–5.
Ilfeld BM, Loland VJ, Gerancher JC, Wadhwa AN, Renehan EM, Sessler DI, Shuster JJ, Theriaque DW, Maldonado RC, Mariano ER. PAINfRE investigators: the effects of varying local anesthetic concentration and volume on continuous popliteal sciatic nerve blocks: a dual-center, randomized, controlled study. Anesth Analg. 2008;107:701–7.
Ilfeld BM, Fredrickson MJ, Mariano ER. Ultrasound-guided perineural catheter insertion: three approaches but few illuminating data. Reg Anesth Pain Med. 2010;35:123–6.
Karmakar MK, Shariat AN, Pangthipampai P, Chen J. High-definition ultrasound imaging defines the paraneural sheath and the fascial compartments surrounding the sciatic nerve at the popliteal fossa. Reg Anesth Pain Med. 2013;38:447–51.
Nader A, Kendall MC, Candido KD, Benzon H, McCarthy RJ. A randomized comparison of a modified intertendinous and classic posterior approach to popliteal sciatic nerve block. Anesth Analg. 2009;108:359–63.
Paqueron X, Narchi P, Mazoit J-X, Singelyn F, Bénichou A, Macaire P. A randomized, observer-blinded determination of the median effective volume of local anesthetic required to anesthetize the sciatic nerve in the popliteal fossa for stimulating and nonstimulating perineural catheters. Reg Anesth Pain Med. 2009;34:290–5.
Perlas A, Wong P, Abdallah F, Hazrati L-N, Tse C, Chan V. Ultrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study. Reg Anesth Pain Med. 2013;38:218–25.
Sala-Blanch X, Vandepitte C, Laur JJ, Horan P, Xu D, Reina MA, Karmakar MK, Clark TB, Hadzic A. A practical review of perineural versus intraneural injections: a call for standard nomenclature. Int Anesthesiol Clin. 2011;49:1–12.
Short AJ, Ghosh M, Jin R, Chan VWS, Chin KJ. Intermittent bolus versus continuous infusion popliteal sciatic nerve block following major foot and ankle surgery: a prospective randomized comparison. Reg Anesth Pain Med. 2019;44:1053–8.
Taboada M, Rodríguez J, Valiño C, Carceller J, Bascuas B, Oliveira J, Alvarez J, Gude F, Atanassoff PG. What is the minimum effective volume of local anesthetic required for sciatic nerve blockade? A prospective, randomized comparison between a popliteal and a subgluteal approach. Anesth Analg. 2006;102:593–7.
Tsui BCH, Finucane BT. The importance of ultrasound landmarks: a “traceback” approach using the popliteal blood vessels for identification of the sciatic nerve. Reg Anesth Pain Med. 2006;31:481–2.
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Pawa, A., Chin, K.J. (2022). Popliteal Sciatic Nerve Block. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_60
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DOI: https://doi.org/10.1007/978-3-030-88727-8_60
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