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Sciatic Nerve Block in Popliteal Fossa

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https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#1
Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27687448/the-effect-of-obesity-on-the-anatomical-relationship-of-the-popliteal-artery-and-tibial-nerve-in-the-proximal-and-distal-popliteal-fossa-relevance-to-popliteal-sciatic-nerve-block-and-a-traceback-technique-using-the-popliteal-artery
#2
Glenn E Woodworth, Jason Trujillo, Erik Foss, Michael Semenza
STUDY OBJECTIVE: To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa. DESIGN: Prospective, observational study. SETTING: University medical center. SUBJECTS: One hundred patients scheduled for magnetic resonance imaging scans of the knee. MEASUREMENTS: BMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27442773/interfascial-spread-of-injectate-after-adductor-canal-injection-in-fresh-human-cadavers
#3
Pierre Goffin, Jean-Pierre Lecoq, Vincent Ninane, Jean Francois Brichant, Xavi Sala-Blanch, Philippe E Gautier, Pierre Bonnet, Alain Carlier, Admir Hadzic
The adductor canal block has become a common analgesic technique in patients undergoing knee arthroplasty. Dispersion of local anesthetic outside the adductor canal through interfascial layers and blockade of smaller nerves that confer innervation to the knee could contribute to the analgesic efficacy of the adductor canal block. We studied the diffusion of local anesthetic mixed with dye after injection into the adductor canal in fresh human cadavers. In all 8 legs, injectate was found in the popliteal fossa in contact with the sciatic nerve and/or popliteal blood vessels...
August 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27314695/the-use-of-electrical-impedance-to-identify-intraneural-needle-placement-in-human-peripheral-nerves-a-study-on-amputated-human-limbs
#4
Amaresh Vydyanathan, Boleslav Kosharskyy, Singh Nair, Karina Gritsenko, Ryung S Kim, Dan Wang, Naum Shaparin
BACKGROUND: Even as the use of peripheral nerve blockade in the perioperative setting is increasing, neural injury secondary to accidental intraneural injection remains a significant patient safety concern. Current modalities, including electrical stimulation and ultrasound imaging, still lack consistency and absolute reliability in both the detection and prevention of this complication. The measurement of electrical impedance (EI) could be an easy and valuable additional tool to detect intraneural needle placement...
July 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26861147/ultrasound-guided-popliteal-sciatic-nerve-blockade-in-the-severely-and-morbidly-obese-a-prospective-and-randomized-study
#5
José R Soberón, Carrie McInnis, Kim S Bland, Allison L Egger, Matthew E Patterson, Clint E Elliott, Robert J Treuting, Kristie Osteen
PURPOSE: Limited research data exist regarding optimal block techniques in the severely and morbidly obese patient population. We compared two approaches to sciatic nerve blockade at the popliteal fossa in severely and morbidly obese patients. The purpose of this study was to identify differences in pain scores, block onset characteristics, and adverse events between the proximal (prebifurcation) and the distal (postbifurcation) sites. METHODS: Patients with a body mass index ≥35 scheduled for unilateral foot surgery with a popliteal block were randomized to receive an ultrasound-guided popliteal block proximal or distal to the bifurcation of the sciatic nerve...
June 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26678473/distribution-of-injectate-and-sensory-motor-blockade-after-adductor-canal-block
#6
Philippe E Gautier, Admir Hadzic, Jean-Pierre Lecoq, Jean Francois Brichant, Maxine M Kuroda, Catherine Vandepitte
BACKGROUND: The analgesic efficacy reported for the adductor canal block may be related to the spread of local anesthetic outside the adductor canal. METHODS: Fifteen patients undergoing knee surgery received ultrasound-guided injections of local anesthetic at the level of the adductor hiatus. Sensory-motor block and spread of contrast solution were assessed. RESULTS: Sensation was rated as "markedly diminished" or "absent" in the saphenous nerve distribution and "slightly diminished" in the sciatic nerve territory without motor deficits...
January 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26442393/ultrasound-guided-sciatic-politeal-nerve-block-a-comparison-of-separate-tibial-and-common-peroneal-nerve-injections-versus-injecting-proximal-to-the-bifurcation
#7
COMPARATIVE STUDY
Magdy H Eldegwy, Sami M Ibrahim, Samy Hanora, Elsayed Elkarta, Ayman S Elsily
OBJECTIVE: Block of the sciatic nerve at the popliteal fossa can be performed using the ultrasound machine; it may be proximally or distally to the bifurcation of the sciatic nerve using lateral, medial, or posterior approaches. It is frequently used for surgeries below the knee specially the foot and ankle operations. PURPOSE: This study compares one and two injections of the sciatic nerve in the popliteal fossa with ultrasound-guided block in foot or ankle surgeries...
June 2015: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/26121819/-the-distance-between-the-sciatic-nerve-bifurcation-and-popliteal-fossa-in-japanese
#8
Naoya Akasaka, Tomoki Sasakawa, Yoshiko Onodera, Shigeaki Otomo, Hiroshi Iwasaki
BACKGROUND: The bifurcation into tibial nerve and common peroneal nerve is generally targeted for sciatic nerve block at popliteal approach. However, it is sometimes difficult to determine the exact bifurcation point in clinical situation. The mean distance between the popliteal fossa and division of sciatic nerve (DPDSN) was reported approximately 6 cm ± 2.5 cm in Caucasian cadaver study. We also studied DPDSN in Japanese cadaver to find ethnic difference. METHODS: We dissected and recorded DPDSN and distance from gluteal fold to heel (foot length : FL) in 15 cadavers...
February 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/25925028/anatomical-basis-for-sciatic-nerve-block-at-the-knee-level
#9
Fabiano Timbó Barbosa, Tatiana Rosa Bezerra Wanderley Barbosa, Rafael Martins da Cunha, Amanda Karine Barros Rodrigues, Fernando Wagner da Silva Ramos, Célio Fernando de Sousa-Rodrigues
BACKGROUND AND OBJECTIVES: Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fossa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve...
May 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/25675792/-optimization-of-the-sciatic-nerve-blockade-as-a-methods-of-anesthesia-analgesia
#10
M L Homon
Developmented and introduction into clinical practice of the sciatic nerve blockade as method of guided anesthesia/analgesia for pain syndromes and surgical interventions on the lower legs. Anaesthesia was analyzed in 35 patients. In 15 patients used the blockade of the sciatic nerve bifurcation proposed method with the popliteal fossa in acute and chronic pain syndromes and comparison with spinal anesthesia in 20. Blockade of the sciatic nerve at the site of its bifurcation provides a highly efficient and long-lasting nerve block zones of innervation is sufficient to perform the surgery...
October 2014: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/25458839/-anatomical-basis-for-sciatic-nerve-block-at-the-knee-level
#11
Fabiano Timbó Barbosa, Tatiana Rosa Bezerra Wanderley Barbosa, Rafael Martins da Cunha, Amanda Karine Barros Rodrigues, Fernando Wagner da Silva Ramos, Célio Fernando de Sousa-Rodrigues
BACKGROUND AND OBJECTIVES: Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fossa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve...
May 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/25394377/a-novel-concept-for-continuous-peripheral-nerve-blocks-presentation-of-a-new-ultrasound-guided-device
#12
C Rothe, C Steen-Hansen, M H Madsen, K H W Lange
BACKGROUND: Existing techniques for placing and maintaining the position of peripheral nerve catheters are associated with variable success rates and frequent secondary failures. These factors may affect the clinical efficacy and usefulness of peripheral nerve catheters. METHODS: We developed a new concept and prototype for ultrasound-guided in-plane positioning and readjustment of peripheral nerve catheters (patent pending). The integrated catheter-needle prototype comprises three parts: a curved needle, a catheter with clear echogenic markings attached to the needle tail and a detachable hub allowing injection of local anesthetic while advancing the needle in the tissue...
February 2015: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/25302181/study-on-variant-anatomy-of-sciatic-nerve
#13
Mallikarjun Adibatti, Sangeetha V
INTRODUCTION: Sciatic Nerve (SN) is the nerve of the posterior compartment of thigh formed in the pelvis from the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica...
August 2014: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/24556512/ultrasound-guided-injection-inside-the-common-sheath-of-the-sciatic-nerve-at-division-level-has-a-higher-success-rate-than-an-injection-outside-the-sheath
#14
RANDOMIZED CONTROLLED TRIAL
A M Lopez, X Sala-Blanch, R Castillo, A Hadzic
BACKGROUND AND OBJECTIVE: The recommendations for the level of injection and ideal placement of the needle tip required for successful ultrasound-guided sciatic popliteal block vary among authors. A hypothesis was made that, when the local anesthetic is injected at the division of the sciatic nerve within the common connective tissue sheath, the block has a higher success rate than an injection outside the sheath. METHODS: Thirty-four patients scheduled for hallux valgus repair surgery were randomized to receive either a sub-sheath block (n=16) or a peri-sheath block (n=18) at the level of the division of the sciatic nerve at the popliteal fossa...
June 2014: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/24346042/effects-of-opioids-on-local-anesthesia-in-the-rat-a-codeine-and-tramadol-study
#15
Talita Girio Carnaval, Roberta Moura Sampaio, Camila Bernadeli Lanfredi, Maria Aparecida Borsatti, Carlos Alberto Adde
Opioids are central analgesics that act on the CNS (central nervous system) and PNS (peripheral nervous system). We investigated the effects of codeine (COD) and tramadol (TRAM) on local anesthesia of the sciatic nerve. Eighty Wistar male rats received the following SC injections in the popliteal fossa: local anesthetic with epinephrine (LA); local anesthetic without vasoconstrictor (LA WV); COD; TRAM; LA + COD; LA + TRAM; COD 20 minutes prior to LA (COD 20' + LA) or TRAM 20 minutes prior to LA (TRAM 20' + LA)...
November 2013: Brazilian Oral Research
https://www.readbyqxmd.com/read/24317232/ultrasound-guided-single-penetration-dual-injection-block-for-leg-and-foot-surgery-a-prospective-randomized-double-blind-study
#16
RANDOMIZED CONTROLLED TRIAL
Jens Børglum, Karina Johansen, Margrethe D Christensen, Katja Lenz, Thomas F Bendtsen, Katrine Tanggaard, Anders F Christensen, Bernhard Moriggl, Kenneth Jensen
BACKGROUND AND OBJECTIVES: We describe a new approach to blocking the sciatic and saphenous nerves in the proximal thigh (level of the lesser trochanter or immediately below) using a single-penetration dual-injection (SPEDI) technique. The popliteal-sciatic approach necessitates repositioning of the leg exposing the popliteal fossa and an extra injection for the saphenous nerve (SAN) block at the midthigh level. We introduce an alternative, effective, and possibly faster method. METHODS: Sixty patients undergoing leg and foot surgery under general anesthesia were included...
January 2014: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/23897425/high-definition-ultrasound-imaging-defines-the-paraneural-sheath-and-the-fascial-compartments-surrounding-the-sciatic-nerve-at-the-popliteal-fossa
#17
Manoj Kumar Karmakar, Ali Nima Shariat, Pawinee Pangthipampai, Junping Chen
BACKGROUND AND OBJECTIVES: The connective tissue layers that surround the sciatic nerve at the popliteal fossa are poorly defined. We present high-definition ultrasound images of the sciatic nerve, which were acquired during ultrasound-guided popliteal sciatic nerve block (SNB), that clearly demonstrate these fascial layers. METHODS: Four patients undergoing hallux valgus surgery received an ultrasound-guided popliteal SNB using a high-definition ultrasound system...
September 2013: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/23815833/sciatic-nerve-high-division-two-different-anatomical-variants
#18
Diogo Pais, Diogo Casal, Maria Alexandre Bettencourt Pires, Andrea Furtado, Tiago Bilhim, Maria Angélica-Almeida, João Goyri-O'Neill
INTRODUCTION: Sciatic nerve variations are relatively common. These variations are often very significant in several fields of Medicine. The purpose of this paper is to present two such variants and discuss their clinical implications. MATERIAL AND METHODS: Three Caucasian cadavers with no prior history of lower limb trauma or surgery were dissected and found to present anatomical variants of the sciatic nerve. RESULTS: In all cases the sciatic nerve divided above the popliteal fossa...
May 2013: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/23770190/techniques-of-popliteal-nerve-regional-anesthesia
#19
Corine Creech, Andrew J Meyr
Regional anesthesia for blockade of the sciatic nerve in the popliteal fossa is a useful adjunct to pain management in the perioperative setting for foot and ankle surgeons. The present tip aimed to provide a review of the relevant anatomy and technique for popliteal nerve block from the posterior and lateral approaches and to provide discussion and images of the use of peripheral nerve stimulation and ultrasound guidance as adjuvant methods to improve efficacy and reproducibility.
September 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/23558372/ultrasound-guided-popliteal-block-through-a-common-paraneural-sheath-versus-conventional-injection-a-prospective-randomized-double-blind-study
#20
RANDOMIZED CONTROLLED TRIAL
Anahi Perlas, Patrick Wong, Faraj Abdallah, Lili-Naz Hazrati, Cyrus Tse, Vincent Chan
BACKGROUND AND OBJECTIVES: The macroscopic anatomy of a common paraneural sheath that surrounds the sciatic nerve in the popliteal fossa has been studied recently in a human cadaveric study. It has been suggested that an injection through this sheath could be an ideal location for local anesthetic administration for popliteal block. The aim of the present study was to evaluate the hypothesis that popliteal sciatic nerve blockade through a common paraneural sheath results in shorter onset time when compared with conventional postbifurcation injection external to the paraneural tissue...
May 2013: Regional Anesthesia and Pain Medicine
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