SN is comprised of lumbosacral trunk (L4, L5) and ventral rami of sacral plexus S1, S2, S3
SN trunk is composed of 2 distinct nerves wrapped in common paraneural sheath
TN
CPN
Provides sensory innervation to skin of lateral leg and foot as well as posterolateral leg and entire posterior foot
Posterior thigh is innervated by posterior femoral cutaneous nerve (branch of SN)
Provides innervation to distal posterior femur, majority of tibia, fibula, and foot bone
Provides innervation to hamstring muscles as well as leg and foot muscles
SN block can be performed at different levels and using different approaches
Gluteal posterior approach
Anterior/midthigh approach: Helpful in patient's who cannot tolerate prone or lateral positioning; easiest in children or thin patients
Popliteal approach
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
OUTCOMES
Problems
Complications
Selected References
Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
Yamamoto H et al: A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block. Anesth Analg. 119(6):1442-8, 2014
Perlas A et al: Ultrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study. Reg Anesth Pain Med. 38(3):218-25, 2013
Germain G et al: Brief reports: a comparison of an injection cephalad or caudad to the division of the sciatic nerve for ultrasound-guided popliteal block: a prospective randomized study. Anesth Analg. 114(1):233-5, 2012
Tran DQ et al: A randomized comparison between subepineural and conventional ultrasound-guided popliteal sciatic nerve block. Reg Anesth Pain Med. 36(6):548-52, 2011
Buys MJ et al: Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injecting proximal to the bifurcation. Anesth Analg. 110(2):635-7, 2010
Prasad A et al: Ultrasound-guided popliteal block distal to sciatic nerve bifurcation shortens onset time: a prospective randomized double-blind study. Reg Anesth Pain Med. 35(3):267-71, 2010
Bruhn J et al: Visualization of the course of the sciatic nerve in adult volunteers by ultrasonography. Acta Anaesthesiol Scand. 52(9):1298-302, 2008
Sladjana UZ et al: Microanatomical structure of the human sciatic nerve. Surg Radiol Anat. 30(8):619-26, 2008
SUNDERLAND S et al: The intraneural topography of the sciatic nerve and its popliteal divisions in man. Brain. 71(Pt. 3):242-73, 1948
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
TERMINOLOGY
Abbreviations
Tibial nerve (TN)
Common peroneal nerve (CPN)
Sciatic nerve (SN)
Synonyms
Popliteal nerve block
Definitions
SN is comprised of lumbosacral trunk (L4, L5) and ventral rami of sacral plexus S1, S2, S3
SN trunk is composed of 2 distinct nerves wrapped in common paraneural sheath
TN
CPN
Provides sensory innervation to skin of lateral leg and foot as well as posterolateral leg and entire posterior foot
Posterior thigh is innervated by posterior femoral cutaneous nerve (branch of SN)
Provides innervation to distal posterior femur, majority of tibia, fibula, and foot bone
Provides innervation to hamstring muscles as well as leg and foot muscles
SN block can be performed at different levels and using different approaches
Gluteal posterior approach
Anterior/midthigh approach: Helpful in patient's who cannot tolerate prone or lateral positioning; easiest in children or thin patients
Popliteal approach
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
OUTCOMES
Problems
Complications
Selected References
Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
Yamamoto H et al: A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block. Anesth Analg. 119(6):1442-8, 2014
Perlas A et al: Ultrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study. Reg Anesth Pain Med. 38(3):218-25, 2013
Germain G et al: Brief reports: a comparison of an injection cephalad or caudad to the division of the sciatic nerve for ultrasound-guided popliteal block: a prospective randomized study. Anesth Analg. 114(1):233-5, 2012
Tran DQ et al: A randomized comparison between subepineural and conventional ultrasound-guided popliteal sciatic nerve block. Reg Anesth Pain Med. 36(6):548-52, 2011
Buys MJ et al: Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injecting proximal to the bifurcation. Anesth Analg. 110(2):635-7, 2010
Prasad A et al: Ultrasound-guided popliteal block distal to sciatic nerve bifurcation shortens onset time: a prospective randomized double-blind study. Reg Anesth Pain Med. 35(3):267-71, 2010
Bruhn J et al: Visualization of the course of the sciatic nerve in adult volunteers by ultrasonography. Acta Anaesthesiol Scand. 52(9):1298-302, 2008
Sladjana UZ et al: Microanatomical structure of the human sciatic nerve. Surg Radiol Anat. 30(8):619-26, 2008
SUNDERLAND S et al: The intraneural topography of the sciatic nerve and its popliteal divisions in man. Brain. 71(Pt. 3):242-73, 1948
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