Ultrasound Guided Lateral Infra-trochanteric Sciatic Nerve Blockade for Proximal Tibial Surgery: A Novel Technique

Abstract

The lateral infratrochanteric SNB provides anesthesia of the proximal tibial structures innervated by the sciatic nerve to the same degree as other proximal SNB techniques, therefore it is suitable for the anesthesia for near the knee surgeries. It does not require any special patient positioning as other proximal SNB techniques, which makes it useful in in the setting of acute trauma, fracture and back injury where neuraxial anesthesia is relatively contraindicated and also in in the morbidly obese. Ultrasound probe placement, visualization of the sciatic nerve and nerve block needle placement is technically easier than the anterior SNB approach and is not influenced by body habitus. The injection point on the lateral side of the thigh is easily accessible for signs of bleeding and infection and is therefore suitable for continuous nerve block catheter placement. The catheter is less apt to migrate and the lateral positionoing also reduces risk of infection that may occur with the anterior or other proximal SNB techniques