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Sciatic Block
Kimberly Ting, MD; Rafael Vazquez, MD
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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

                                  1. Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
                                  2. 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
                                  3. 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
                                  4. 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
                                  5. 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
                                  6. 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
                                  7. 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
                                  8. 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
                                  9. Sladjana UZ et al: Microanatomical structure of the human sciatic nerve. Surg Radiol Anat. 30(8):619-26, 2008
                                  10. 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

                                                                  1. Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
                                                                  2. 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
                                                                  3. 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
                                                                  4. 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
                                                                  5. 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
                                                                  6. 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
                                                                  7. 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
                                                                  8. 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
                                                                  9. Sladjana UZ et al: Microanatomical structure of the human sciatic nerve. Surg Radiol Anat. 30(8):619-26, 2008
                                                                  10. SUNDERLAND S et al: The intraneural topography of the sciatic nerve and its popliteal divisions in man. Brain. 71(Pt. 3):242-73, 1948