Hadzic's Regional Anesthesia > Part III. Clinical Practice of Regional Anesthesia > Section Six. Blocks for the Lower Extremity > Chapter 38. Block of the Sciatic Nerve in the Popliteal Fossa Jerry D. Vloka, MD, Admir Hadzic, MD

Block of the Sciatic Nerve in the Popliteal Fossa: Introduction

"Distal sciatic nerve block (popliteal fossa block) is a relatively simple technique that results in reliable surgical anesthesia of the calf, tibia, fibula, ankle, and foot.^1,2 Consequently, this technique is used primarily for anesthesia or analgesia for foot, ankle, and lower-leg surgery.³ The sciatic nerve can be approached from either the posterior approach described by Rorie,³ or the lateral approach, which eliminates the need to reposition patients in the supine position.¹ With the lateral popliteal fossa block, patients remain supine for the block and catheter placement, rather than being prone and then turning supine after the block is placed. Both approaches provide equivalent surgical anesthesia after nerve blockade.¹ With both approaches, catheters can be inserted to provide prolonged postoperative analgesia; catheters, however, are more easily secured in the lateral position. Because of the slower resolution of neural blockade in the lower extremity, popliteal fossa block performed with long-acting local anesthetics such as ropivacaine can provide 12–24 hours of analgesia after foot surgery. The remarkable safety of the block has been demonstrated in numerous studies.^3,4The popliteal block is one of the most commonly used regional anesthesia techniques in regional anesthesia practice. Common indications include corrective foot surgery, foot debridement, short saphenous vein stripping, repair of the Achilles tendon, and others.⁸ As opposed to the..."