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Related Experiment Video

Updated: Jun 11, 2026

An In Vivo Murine Sciatic Nerve Model of Perineural Invasion
09:55

An In Vivo Murine Sciatic Nerve Model of Perineural Invasion

Published on: April 23, 2018

A simple approach to the sciatic nerve that does not require geometric calculations or multiple landmarks.

Anupama Wadhwa1, Heather Tlucek, Daniel Sessler

  • 1Department of Anesthesiology and Perioperative Medicine, University Hospital, 530 S. Jackson St., Louisville, KY 40202, USA. anwadh01@louisville.edu

Anesthesia and Analgesia
|December 25, 2009
PubMed
Summary

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A novel approach to sciatic nerve blockade using a landmark 3 cm lateral to the ischial tuberosity requires fewer needle passes and less time for effective lower extremity analgesia.

Area of Science:

  • Anesthesiology
  • Orthopedics
  • Pain Management

Background:

  • Sciatic nerve blockade is crucial for lower extremity analgesia via peripheral nerve blocks.
  • Conventional prone subgluteal approaches may have limitations in identifying the sciatic nerve accurately.
  • Cadaveric and patient studies are essential for refining nerve block techniques.

Purpose of the Study:

  • To compare the efficacy of a novel experimental approach versus the conventional approach for sciatic nerve blockade.
  • To test the hypothesis that the novel approach requires fewer needle passes and less time.
  • To identify a more effective landmark for sciatic nerve identification in the prone position.

Main Methods:

  • Cadaver dissections (n=20) identified sciatic nerve location relative to the ischial tuberosity.

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  • A randomized, controlled, crossover study compared a prone subgluteal (conventional) approach with an experimental approach (3 cm lateral to ischial tuberosity).
  • Number of needle passes and time to achieve sciatic nerve twitch at specific current thresholds were recorded.

    • Main Results:

    • The sciatic nerve was located an average of 2.8 cm from the ischial tuberosity midpoint in cadavers.
    • The experimental approach consistently transected the sciatic nerve, while the conventional approach was often lateral (2.27 cm away).
    • The experimental approach significantly reduced needle passes and improved twitch acquisition success rates compared to the conventional method.

    Conclusions:

    • A novel landmark 3 cm lateral to the ischial tuberosity provides a more effective target for sciatic nerve blockade.
    • This experimental approach offers improved efficiency and success rates for achieving lower extremity analgesia.
    • The findings suggest a superior method for prone sciatic nerve blocks compared to the conventional subgluteal approach.