The absence of motor response to nerve stimulation during popliteal sciatic nerve block does not exclude intraneural needle placement and may lead to additional unnecessary attempts at nerve localization. Additionally, low-current stimulation was associated with a high frequency of intraneural needle placement.

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Over the past decade several developments have lead to an increased interest in lower extremity PNBs including transient neurologic symptoms associated with spinal anesthesia, increased risk of epidural hematoma with the introduction of new antithromboembolic prophylaxis regimens, and evidence of improved rehabilitation outcome with continuous lower extremity PNBs. Simultaneously, the field of lower extremity blockade has been revolutionized through our better understanding of functional regional anesthesia anatomy, introduction of new drugs, better and more sophisticated equipment and wider teaching of lower extremity nerve block techniques. This review focuses on techniques and applications of lower extremity nerve blocks in patients having orthopedic surgery or trauma of the lower extremity, as well as potential complications and means to avoid them.

No abstract