Infragluteal-parabiceps sciatic nerve block: An evaluation of a novel approach using a single-injection technique

Radha Sukhani*, Kenneth D. Candido, Robert Doty Jr, Edward Yaghmour, Robert J McCarthy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Clinical use of the sciatic nerve block (SNB) has been limited by technical difficulties in performing the block using standard approaches, substantial patient discomfort during the procedure, or the need for two injections to block the tibial and peroneal nerves. In this report, we describe a single-injection method for SNB using an infragluteal-parabiceps approach, where the nerve is located along the lateral border of the biceps femoris muscle. SNB was performed in the prone or lateral decubitus position. The needle was positioned (average depth, 56 ± 15 mm) to the point where plantar flexion (53%) or inversion (45%) of the ipsilateral foot was obtained at ≤0.4 mA. Levobupivacaine 0.625% with epinephrine (1:200:000) was administered at a dose of 0.4 mL/kg. The procedure was completed in 6 ± 3 min. Discomfort during block placement was treated with fentanyl 50-100 μg in 24% of patients. Complete sensory loss and motor paralysis occurred in 92% of subjects at a median time of 10 (range, 5-25) min after injection. Compared with plantar flexion, foot inversion was associated with a more frequent incidence (86% versus 100%), and shorter latency for both sensory loss and motor paralysis of the peroneal, tibial, and sural nerves. There were no immediate or delayed complications. We conclude that the infragluteal-parabiceps approach to SNB is reliable, efficient, safe, and well tolerated by patients.

Original languageEnglish (US)
Pages (from-to)868-873
Number of pages6
JournalAnesthesia and Analgesia
Volume96
Issue number3
DOIs
StatePublished - Mar 1 2003

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Infragluteal-parabiceps sciatic nerve block: An evaluation of a novel approach using a single-injection technique'. Together they form a unique fingerprint.

Cite this