Ultrasound-guided Sciatic Nerve Blocks: Higher and Popliteal Approaches

Abstract

Background and objective: In modern anaesthetic practice the classical landmark approaches for sciatic nerve blocks have been constantly modified and adjusted to the ultrasound-guided techniques. This huge variety in published ‘new’ ultrasound SNB approaches may be somewhat confusing for the anaesthetic trainee. In this article we compare most popular ultrasound approaches to the landmark techniques trying to systematize them for teaching purposes. Materials and methods: After reviewing the current literature, publications and websites we describe the four most popular groups of ultrasound approaches for sciatic nerve blocks discussing the sonoanatomy, sonotechnique, clinical tips and complications. We start with the most superficial approach-the popliteal and end with the deepest of them-the anterior approach. We also hope that our classification will even accommodate the US approaches developed in the future.