Sciatic neuropathy due to popliteal fossa nerve block

Abstract

Our results suggest PNB is a relatively common etiology of sciatic neuropathy and is an important consideration in the differential diagnosis. These findings should urge electromyographers to assess history of PNB in sciatic neuropathies, particularly with onset after surgery. Muscle Nerve 56: 822-824, 2017.

Clinical and Electrodiagnostic Features Of Nontraumatic Sciatic Neuropathy

“…Sciatic neuropathy as a complication of knee replacement surgery has been previously reported, and possible risk factors for postoperative nerve injury may include female sex and lumbar pathology . In 1 recent report, popliteal fossa nerve block was described as an etiology for sciatic neuropathy . However, its infrequent usage in patients who underwent knee surgery in this report suggests it may not be a major etiological contributor to this group of postoperative sciatic neuropathies.…”

“…Despite its common occurrence, analyses of the clinical and electrodiagnostic (EDx) features of sciatic neuropathy are rare. Only a few large series have been reported …”

Is temporal association between popliteal‐sciatic block and nerve injury sufficient evidence to assign etiology?

“…We thank Aubuchon for reporting a potential association between popliteal‐sciatic block and sciatic neuropathy based on electrodiagnostic findings . However, our view is that the temporal association between popliteal‐sciatic block and nerve injury is not sufficient evidence to assign etiology, and other possible etiologies should be considered.…”

“…We thank Aubuchon for reporting a potential association between popliteal-sciatic block and sciatic neuropathy based on electrodiagnostic findings. 1 However, our view is that the temporal association between popliteal-sciatic block and nerve injury is not sufficient evidence to assign etiology, and other possible etiologies should be considered. For many surgeries (such as shoulder, hip, or knee arthroplasty), the incidence of postoperative nerve injury is the same regardless of anesthetic technique used.…”

Reply

“…We thank Drs Gray and Barrington for their interest in our work and appreciate their critical appraisal and feedback. They point out that the incidence of long‐term nerve injury is approximately 1 in 3,000 block procedures, with symptoms that improve over time .…”