A modified lateral approach to the sciatic nerve: magnetic resonance imaging simulation and clinical study

Area of Science:

• Anesthesiology
• Radiology
• Anatomy

Background:

• Describes a novel lateral approach for sciatic nerve (SN) blockade in the popliteal fossa.
• Utilizes magnetic resonance imaging (MRI) to assess the feasibility of this new technique.

Purpose of the Study:

• To evaluate a new lateral landmark-based approach for SN block.
• To compare the new technique with the classical landmark using MRI.
• To determine the clinical feasibility and safety of the modified SN block.

Main Methods:

• Reviewed MRI scans of 40 patients to compare a new landmark with the classical one.
• Defined landmarks for the modified technique: upper patella edge and biceps femoris tendon.
• Determined simulated needle direction and depth to the neurovascular bundle via MRI.

Main Results:

• The modified technique significantly reduced the distance to the tibial and common peroneal nerves compared to the classic approach (P < .0001).
• Achieved a high success rate of 94% in 100 patients.
• Reported no complications in the studied cohort, with only 6 cases of SN block failure requiring general anesthesia.

Conclusions:

• A needle insertion below the biceps femoris tendon provides straightforward access to the common peroneal and tibial nerves.
• The modified lateral SN block approach is easy to perform and highly successful.
• This technique demonstrates safety and efficacy in a small patient group.