Lateral approach to the sciatic nerve block in the popliteal fossa: correlation between evoked motor response and sensory block

Abstract

After stimulation of the sciatic nerve, plantar flexion better predicts complete sensory blockade of the foot than dorsiflexion when using the lateral approach to the popliteal fossa. The findings of the present study apply to a single injection of 30 mL of ropivacaine 0.75%.

Parasacral approach to block the sciatic nerve: A 400-case survey

“…[2][3][4][5] The mean time to perform the block and average onset time are also similar to other approaches to the sciatic nerve. 4,[10][11][12] The fact that sensory and motor block occurred almost at the same time for both common peroneal and tibial components is relatively unusual compared with results of other sciatic nerve approaches that use a single injection. 12 At a lower level of block, common peroneal and tibial components are frequently separated, a fact supporting the need for double injection.…”

“…4,[10][11][12] The fact that sensory and motor block occurred almost at the same time for both common peroneal and tibial components is relatively unusual compared with results of other sciatic nerve approaches that use a single injection. 12 At a lower level of block, common peroneal and tibial components are frequently separated, a fact supporting the need for double injection. 13 By contrast, at the level where parasacral block is performed, both components are joined and form a unique nerve, which explains why the evoked response does not appear to influence the success rate.…”

Lateral popliteal sciatic nerve block: a single injection targeting the tibial branch of the sciatic nerve is as effective as a double‐injection technique

“…Statistical analysis was performed with SPSS version 13.0 (SPSS Inc., Chicago, IL). Based on previous studies (4, 8) and our previous clinical experience, we determined that a sample size of 32 patients in each group would have 80% power to detect at least a 5‐min difference in the sensory onset time between groups at α = 0.05. The Kolmogorov–Smirnov test was used to evaluate data distribution, followed by an analysis of variance (ANOVA) and Bonferroni post hoc tests for comparison of independent variables.…”

“…Nor is it clear whether, given the peculiar anatomy of the sciatic nerve at the popliteal level, a single‐injection technique via the lateral approach may be effective only if injected near TN (i.e. within the common epineural sheath), where nerve stimulation exclusively evokes plantar flexion of the foot (8).…”

The Effective Injection Point of the Popliteal Region: A Cadaver Dissection Without Removing the Perineurium

“…Popliteal nerve block (PopNB), often used during surgery to treat spasticity below the knee (Taboada Muñiz et al, 2003;Saleh et al, 2009), is considered relatively safe for providing an appropriate level of spinal anesthesia and reducing its possible side-effects. PopNB is reported to have excellent results regarding postoperative pain control (Jeon et al, 2013).…”