An Ultrasound-Guided Lateral Approach for Proximal Sciatic Nerve Block

Yoshida, Takayuki; Nakamoto, Tetsuji; Hashimoto, Chikara; Aihara, Satoshi; Nishimoto, Kota; Kamibayashi, Takahiko

doi:10.1097/aap.0000000000000835

Cited by 4 publications

(2 citation statements)

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“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8,12,13 Conventional two-dimensional ultrasound machines are limited in terms of the ability to distinguish the SN from the surrounding tissue, 14 which could affect the success rate and effect of the block procedure. In our study, the image quality of the SN was poor in 8 of the 26 patients (30.8%, visibility score <2).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study

Wang¹,

Qu²,

Deng³

et al. 2023

JPR

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Purpose The location of the sciatic nerve deep within the thigh tissue makes it challenging to locate while the patient is in a supine position. The posterior intermuscular septum of the thigh, which encircles the posterior surface of the adductor magnus muscle (AMM), is where the sciatic nerve is located. Our hypothesis was that administering local anesthetic injections into this area could block the sciatic nerve. Therefore, our aim was to evaluate the effectiveness of sciatic nerve block achieved by injecting local anesthetic into the posterior intermuscular septum of the thigh, named the AMM approach. Methods Twenty-six patients undergoing total knee arthroplasty were included in the study. We performed an ultrasound-guided sciatic nerve block by injecting 20 mL of 0.25% ropivacaine into the posterior surface of the adductor magnus muscle, using the AMM approach. Additionally, we administered a femoral nerve block with 20 mL of 0.4% ropivacaine. We assessed the sensory and motor effects of the blockade in the operated lower limb and recorded postoperative pain scores at 0, 4, 8, 12, 24, and 48 hours after the operation. Results The AMM approach successfully block the sciatic nerve in all 26 patients. The onset of the sensory and motor blockades was achieved within 5.4 ± 1.9 min and 8.7 ± 3.5 min, respectively. We achieved a satisfactory position with the first puncture in 19 of 26 patients (73.1%). The muscle strength of the tibialis anterior immediately after surgery was 4 (ranging from 2 to 5). Additional rescue analgesics were required in 5 of the 26 patients (19.2%) during the first 24 hours postoperatively. Conclusion The AMM approach is an innovative and effective method for sciatic nerve block. When combined with simultaneous femoral nerve block in patients undergoing total knee arthroplasty, it provides a useful analgesic treatment option.

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“…However, the depth and anisotropy of the sciatic nerve can make it difficult to visualize, it is still regarded as a time-consuming and advanced technique. 8 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%