Ultrasound-guided Sciatic Nerve Block: Posterior Approach

The sciatic nerve blockade is routinely done for surgery and pain management of the lower extremity and is one of the commonly used techniques in our practice. When performed in a systematic manner, it is associated with a high success rate.1,2 It is particularly well suited for surgery on the knee, calf, ankle and foot. It provides complete anaesthesia of the leg below knee with the exception of the medial strip of skin, which is innervated by the saphenous nerve. When combined with femoral nerve or lumbar plexus block, anaesthesia of almost entire leg is achieved. Ultrasound-guided sciatic nerve block has been described in the recent past.3 Sciatic nerve can be blocked using ultrasound at different levels along the posterior aspect of thigh. This includes gluteal, subgluteal and popliteal approach. Each approach is discussed in detail with description of sonoanatomy and block technique.