A comparison of two approaches to sciatic nerve block

Kilpatrick, A.; Coventry, D.M.; Todd, J.G.

doi:10.1111/j.1365-2044.1992.tb02018.x

Cited by 47 publications

(28 citation statements)

References 8 publications

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“…However, the procedure was significantly less painful with the popliteal approach. 39,40 While Kilpatrick et al 39 reported a better success rate with the transgluteal approach (95 vs 45% of patients; P < 0.01), Fuzier et al 40 found no difference between the two groups (94-98%).…”

Section: Approachesmentioning

confidence: 99%

A review of approaches and techniques for lower extremity nerve blocks

Tran

Clemente

Finlayson

2007

Can J Anesth/J Can Anesth

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Purpose: The purpose of this narrative review is to summarize the evidence derived from randomized controlled trials (RCTs) regarding approaches and techniques for lower extremity nerve blocks.Source: Using the MEDLINE (January 1966 to April 2007 and EMBASE (January 1980 to April 2007 databases, medical subject heading (MeSH) terms "lumbosacral plexus", "femoral nerve", "obturator nerve", "saphenous nerve", "sciatic nerve", "peroneal nerve" and "tibial nerve" were searched and combined with the MESH term "nerve block" using the operator "and". Keywords "lumbar plexus", "psoas compartment", "psoas sheath", "sacral plexus", "fascia iliaca", "three-in-one", "3-in-1", "lateral femoral cutaneous", "posterior femoral cutaneous", "ankle" and "ankle block" were also queried and combined with the MESH term "nerve block". The search was limited to RCTs involving human subjects and published in the English language. Forty-six RCTs were identified. Principal findings:Compared to its anterior counterpart (3-in-1 block), the posterior approach to the lumbar plexus is more reliable when anesthesia of the obturator nerve is required. The fascia iliaca compartment block may also represent a better alternative than the 3-in-1 block because of improved efficacy and efficiency (quicker performance time, lower cost). For blockade of the sciatic nerve, the classic transgluteal approach constitutes a reliable method. Due to a potentially shorter time for sciatic nerve electrolocation and catheter placement than for the transgluteal approach, the subgluteal approach should also be considered. Compared to electrolocation of the peroneal nerve, electrostimulation of the tibial nerve may offer a higher success rate especially with the transgluteal and lateral popliteal approaches. Furthermore, when performing sciatic and femoral blocks with low volumes of local anesthetics, a multiple-injection technique should be used. MeSH « nerve block » à l'aide de l'opérateur « and ». Les mots clés « lumbar plexus », « psoas compartment », « psoas sheath », « sacral plexus », « fascia iliaca », « lateral Conclusions Objectif : L'objectif de cet examen narratif est de résumer les données probantes dérivées d'études randomisées contrôlées (ERC) concernant les approches et techniques pour les blocs nerveux du membre inférieur. Source : A l'aide des bases de données MEDLINE (janvier 1966 à avril 2007) et EMBASE (janvier 1980 à avril 2007), les termes MeSH (vedette-matière médicale) « lumbosacral plexus », « femoral nerve », « obturator nerve », « saphenous nerve », « sciatic nerve », « peroneal nerve » et « tibial nerve » ont été recherchés et combinés au terme

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Section: Approachesmentioning

confidence: 99%

A review of approaches and techniques for lower extremity nerve blocks

Tran

Clemente

Finlayson

2007

Can J Anesth/J Can Anesth

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“…In the study by A. W. Kilpatrick et al, it is proved that the rate of the development of the sciatic nerve blockade performed with alkalinized 0.5% bupivacaine with epinephrine (1:200,000) does not depend on the approach (classic gluteal approach or popliteal approach) [5]. M. Taboada et al have found out that when the sciatic nerve is blocked with ropivacaine or mepivacaine sensory blocks develop faster when regional blockade of the sciatic nerve is performed in the proximal areas rather than in distal areas [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Time Development of the Sciatic Nerve Blockade Performed with 1% Lidocaine Subgluteal and Popliteal Approach under Ultrasound Guidance

Valery¹,

Aliaksei²,

Brukhnou³

et al. 2014

OJAnes

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The existing researches in the field of regional anesthesia of the sciatic nerve show that if popliteal sciatic nerve blockade is performed, the time of the development of the sciatic nerve anesthesia is longer in comparison with subgluteal sciatic nerve blockade. Background: The aim of the research is to compare the time of the development of the sciatic nerve blockade performed with 1% lidocaine with epinephrine (1:200,000) in subgluteal and popliteal areas under ultrasound guidance. Materials and Methods: Patients were divided into two groups. In Group A (20 patients), the subgluteal approach to block the sciatic nerve was taken; in Group B (20 patients), the popliteal approach was applied. All blockades of the sciatic nerve were performed with 1% lidocaine (30 ml of lidocaine with epinephrine (1:200,000)) and electrical stimulation of peripheral nerves under ultrasound guidance. We measured the time of the development of sensory and motor blocks. Results: In Group A, the sciatic nerve sensory block developed in 15 (14 -16) minutes, a complete motor block developed in 15.5 (15 -17) minutes. In Group B the sciatic nerve sensory block developed in 40 (38.5 -42.5) minutes while a complete motor block did not develop in any patient. Conclusion: When the sciatic nerve is blocked in subgluteal area with 30 ml of 1% lidocaine with epinephrine (1:200,000) under ultrasound guidance, sensory blocks develop faster than during the popliteal blockade: 15 (14 -16) minutes vs. 40 (38.5 -42.5) minutes respectively. The opportunity to define the place of the introduction of local anesthetic in our research is limited.

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“…However, comparisons with other studies remain difficult because of the lack of complete and detailed results. 2,3,14 C Co on nc cl lu us si io on n Sciatic nerve anesthesia using the novel lateral technique described appears to be a useful technique for distal lower limb surgery. Compared to the previously described peripelvic or popliteal methods, the present technique offers the advantages of the supine position for performing the block and catheter insertion with a high rate of homogeneous anesthesia and a low incidence of side effects.…”

Section: Figurementioning

confidence: 99%

“…We reviewed the sensitive and motor blocks reported with bupivacaine containing anesthetic solutions using different approaches, 2,3,6,14 to the sciatic nerve (Table II). Our results confirm the high incidence and rapid onset of blockade of both the proximal and the distal trunks of the sciatic nerve.…”

Section: Objectifmentioning

confidence: 99%

“…[2][3][4] Compared to the popliteal 4,5 and the midfemoral 6 approaches recently reported, a more proximal block, near the lateral cutaneous projection of the femoral trochanter major, could provide a complete and homogeneous anesthesia of the sciatic nerve, including the posterior cutaneous nerve. A new device for deep nerve or plexus location and catheter insertion being available, a novel lateral landmark for sciatic nerve block was developed to combine firstly, ease of performance on a supine patient, secondly, a puncture site allowing a complete blockade of the sciatic nerve, and thirdly, plexal catheter placement for postoperative analgesia.…”

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confidence: 99%

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Sciatic nerve blockade in the supine position: a novel approach

Pandin

Vandesteene

D’Hollander

2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Sciatic nerve block is useful for surgery below the knee both intra-and postoperatively. Several techniques to insert a catheter at the knee level or higher have been described but need mobilization (lateral decubitus) of the patient. We describe novel landmarks, using a high lateral approach, to block the sciatic nerve without moving the patient.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : One hundred seven ASA I, II and III ASA patients scheduled for major foot or ankle surgery were studied prospectively. With patients awake and lying in the supine position, the catheter was introduced along novel landmarks in the peri-nervous adipose space using specifically designed material and nerve stimulation (< 0.5 mA). After a negative test dose (1% lidocaine with 1/200.000 epinephrine), 10 mL of 0.5% bupivacaine and 10 mL of 2% lidocaine were injected. Thirty minutes after performance of the block, the cutaneous and dermatomal sensory blockade were assessed using cold and pinprick tests while motor block was assessed using a modified Bromage scale. Complications and incidents were recorded. The tibial and superficial peroneal nerve were always blocked, while the deep peroneal and posterofemoral cutaneous nerves were blocked in only 97% and 83% of the patients, respectively. Anesthesia, was always present in the dermatome L5 and in the S1 dermatome in 98% of the patients. No major incidents or complications were noted. Three catheters could not be inserted and the anesthestic solution was injected through the needle.

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A comparison of two approaches to sciatic nerve block

Cited by 47 publications

References 8 publications

A review of approaches and techniques for lower extremity nerve blocks

A review of approaches and techniques for lower extremity nerve blocks

Comparison of Time Development of the Sciatic Nerve Blockade Performed with 1% Lidocaine Subgluteal and Popliteal Approach under Ultrasound Guidance

Sciatic nerve blockade in the supine position: a novel approach

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