Effects of Ultrasound Guidance and Neurostimulation on the Minimum Effective Anaesthetic Volume (MEAV) of Mepivacaine 1.5% for Sciatic Nerve Blockade

Sciatic nerve blockade is performed to achieve anesthesia and analgesia of the distal lower extremity, including the anterior and posterolateral leg, ankle, and foot. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance is also discussed.

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547. Effects of Ultrasound Guidance and Neurostimulation on the Minimum Effective Anaesthetic Volume (MEAV) of Mepivacaine 1.5% for Sciatic Nerve Blockade

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-00115550-200809001-00022 ◽

2008 ◽

Vol 33 (Suppl 1) ◽

pp. e13.1-e13

Author(s):

G. Danelli ◽

E. Moschini ◽

M. C. Iacopini ◽

E. Rizzi ◽

D. Gemmi ◽

...

Keyword(s):

Sciatic Nerve ◽

Ultrasound Guidance ◽

Nerve Blockade

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Comparison of Time Development of the Sciatic Nerve Blockade Performed with 1% Lidocaine Subgluteal and Popliteal Approach under Ultrasound Guidance

Open Journal of Anesthesiology ◽

10.4236/ojanes.2014.412046 ◽

2014 ◽

Vol 04 (12) ◽

pp. 324-331

Author(s):

Piacherski Valery ◽

Marachkou Aliaksei ◽

Brukhnou Andrei ◽

Zakhar Kokhan

Keyword(s):

Sciatic Nerve ◽

Ultrasound Guidance ◽

Time Development ◽

Nerve Blockade

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547: Effects of Ultrasound Guidance and Neurostimulation on the Minimum Effective Anaesthetic Volume (MEAV) of Mepivacaine 1.5% for Sciatic Nerve Blockade

Regional Anesthesia and Pain Medicine ◽

10.1016/j.rapm.2008.07.027 ◽

2008 ◽

Vol 33 (5) ◽

pp. e13-e13

Author(s):

G DANELLI ◽

E MOSCHINI ◽

M IACOPINI ◽

E RIZZI ◽

D GEMMI ◽

...

Keyword(s):

Sciatic Nerve ◽

Ultrasound Guidance ◽

Nerve Blockade

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Combined femoral and sciatic nerve blockade for lower limb surgeries: ultrasound guidance versus nerve stimulation

Zagazig University Medical Journal ◽

10.21608/zumj.2019.7252.1036 ◽

2019 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Samar Hassan ◽

Khaled Shawky ◽

Zainab Attia ◽

Nahla Amin ◽

Zainab Sawan ◽

...

Keyword(s):

Sciatic Nerve ◽

Nerve Stimulation ◽

Lower Limb ◽

Ultrasound Guidance ◽

Nerve Blockade

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Faculty Opinions recommendation of Is a patella motor response necessary for continuous femoral nerve blockade performed in conjunction with ultrasound guidance?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.9683956.10363054 ◽

2011 ◽

Author(s):

Alan Macfarlane ◽

Rachel Kearns

Keyword(s):

Motor Response ◽

Ultrasound Guidance ◽

Femoral Nerve ◽

Nerve Blockade

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Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Open Medicine ◽

10.1515/med-2019-0034 ◽

2019 ◽

Vol 14 (1) ◽

pp. 346-353

Author(s):

Benedikt Büttner ◽

Alexander Schwarz ◽

Caspar Mewes ◽

Katalin Kristof ◽

José Hinz ◽

...

Keyword(s):

Sciatic Nerve ◽

Local Anesthetic ◽

Ultrasound Guidance ◽

Resonance Imaging ◽

Nerve Blocks ◽

Cross Sectional ◽

Neurological Sequelae ◽

Patient Reported ◽

Study Population ◽

Intraneural Injection

AbstractIntraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath.The study population included patients undergoing lower extremity surgery under popliteal sciatic nerve block. Ultrasound-guidance was used to position the needle tip subparaneurally and to monitor the injection of the local anesthetic. Sonography and magnetic resonance imaging were used to assess the extent of the subparaneural injection.Twenty-two patients participated. The median sciatic cross-sectional area increased from 57.8 mm2 pre-block to 110.8 mm2 immediately post-block. An intraneural injection according to the current definition was seen in 21 patients. Two patients had sonographic evidence of an intrafascicular injection, which was confirmed by MRI in one patient (the other patient refused further examinations). No patient reported any neurological symptoms.A subparaneural injection in the popliteal segment of the distal sciatic nerve is actually rarely intraneural, i.e. intrafascicular. This may explain the discrepancy between the conventional sonographic evidence of an intraneural injection and the lack of neurological sequelae.

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