Ultrasound‐guided parasacral approach to the sciatic nerve block in children

Dillow, Jennifer; Rosett, Randy L.; Petersen, Timothy R.; Vagh, Firoz; Hruschka, James A.; Lam, Nicholas

doi:10.1111/pan.12194

Cited by 13 publications

(15 citation statements)

References 16 publications

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“…There were 23 and 13 articles reporting quality and outcomes of ultrasound imaging for the pediatric population in peripheral and neuraxial blockade, respectively ( Table 2). From the peripheral nerve block (PNB) set, there were 10 RCTs, 4-13 6 prospective observational studies, [14][15][16][17][18][19] 2 retrospective studies, 20,21 and 5 case series [22][23][24][25][26] (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…22 In another prospective observational study for 19 children undergoing lower limb surgery, the success rate of an ultrasound-guided parasacral approach to sciatic nerve blockade was 100%. 19 In children listed for circumcision, Faraoni et al 6 reported a 100% block success with ultrasound guidance for dorsal penile nerve blocks compared with a 90% success rate using the landmark technique (P = 0.5). In a case series of 40 children receiving an ultrasound-guided sciatic perineural catheter for congenital talipoequinovarus surgery, 23 block success was 97.5%, with only 1 child with inadequate pain relief requiring postoperative rescue analgesia.…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

“…19 Ponde et al, 23 Van Geffen et al 25 Trunk: Alsaeed et al, 26 Boretsky et al, 21 Ford et al, 15 Hong et al, 16 4 Ponde and Diwan 10…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

“…Lower extremity: Dillow et al, 19 Ponde et al, 9,22,23 • For sciatic nerve blocks, the success of US-guided block does not depend on ability to elicit motor response with NS. 5 Faraoni et al, 6 Gurnaney et al, 7 Sahin et al, 13 …”

Section: Ib a (Us Vs Ns)mentioning

confidence: 99%

“…Ultrasound imaging allows for accurate identification of nerves as well as important anatomical structures 15,19,25,26 and can aid in the placement of the needle/catheter. 21,25 Three studies 21,23,24 reported being able to visualize the needle tip in all patients, and 1 study 23 reported visualization of the catheter tip in 73% of sciatic perineural catheter placements in children listed for congenital talipoequinovarus surgery.…”

Section: B (Sufficient Postoperative Analgesia)mentioning

confidence: 99%

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Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia

Lam

Corry

Tsui

2016

Regional Anesthesia and Pain Medicine

114

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Studies in the current review provide stronger evidence and have addressed a number of outcomes that were previously inconsistent or lacked strength in evidence. In the current systematic review, we identified more studies in a shorter period compared with the previous review, and these studies contain higher levels of evidence compared with what we previously found. Randomized controlled trials and well-designed prospective observational studies have replaced case series. Stronger evidence from the literature suggests that ultrasound-guided peripheral blocks decrease block performance time when compared with nerve stimulation (but take longer than the landmark technique), increase block success, and increase block quality (as measured by analgesic consumption, block duration, and pain scores). Ultrasound guidance in neuraxial blocks improves needling time, predicts epidural depth, allows visualization of the catheter and local anesthetic spread, and improves block quality. Furthermore, we identified 2 large-scale prospective studies describing the incidence of adverse events and complications in pediatric regional anesthesia. The increase in evidence presented in this review reflects the efficacy and prevalent use of ultrasound imaging in pediatric regional anesthesia.

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Section: Resultsmentioning

confidence: 99%

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

“…19 Ponde et al, 23 Van Geffen et al 25 Trunk: Alsaeed et al, 26 Boretsky et al, 21 Ford et al, 15 Hong et al, 16 4 Ponde and Diwan 10…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Section: Ib a (Us Vs Ns)mentioning

confidence: 99%

Section: B (Sufficient Postoperative Analgesia)mentioning

confidence: 99%

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Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia

Lam

Corry

Tsui

2016

Regional Anesthesia and Pain Medicine

114

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Revisiting the surface anatomy of the sciatic nerve in the gluteal region in children using computed tomography

2015

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No anatomy text specifically describes the course of the sciatic nerve (SN) in the gluteal region in children. Anatomical information is largely derived from cadaveric studies of adults, so accurate anatomical information about the location of the SN in children is required. The aim of this study is to assess the surface anatomy of the SN in children using computed tomography (CT). After excluding studies with pelvic pathology, 75 CT scans were analyzed. Three groups were selected for analysis (0-2, 4-6, and 8-10 years). The position of the SN was measured between the posterior superior iliac spine (PSIS) and the ischial tuberosity (IT) and between the IT and the greater trochanter (GT) using 3-dimensional images. In the 0-2 age group, the SN crossed the middle third of a line between the PSIS and the IT in 94% and the GT and the IT in 80% of cases. In the 4-6 age group, the SN crossed the middle third of a line between the PSIS and the IT in 96% and the GT and the IT in 87%. In the 8-10 age group, the SN crossed the middle third of a line between the PSIS and the IT in 100% and the GT and the IT in 71%. The findings indicate that the SN in children is most accurately located in the middle third along a line drawn from the PSIS to the IT and the GT to the IT. Our study is the first to provide anatomical CT data from living children to guide interventions in the gluteal region.

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