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Ultrasound‐Guided Anterior Approach to a Sciatic Nerve Block
Author(s) -
Kim HaJung,
Chin Ki Jinn,
Kim Hyungtae,
Jang Hwayoung,
Bin Seongil,
Ro Youngjin,
Koh Won Uk
Publication year - 2020
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.15258
Subject(s) - medicine , sciatic nerve , visibility , ultrasound , nerve block , anatomy , block (permutation group theory) , ultrasound imaging , ultrasonography , anesthesia , surgery , radiology , geometry , optics , physics , mathematics
Objectives We aimed to identify the optimal lower limb position for an ultrasound (US)‐guided anterior approach to a sciatic nerve block. Methods We included 45 patients who met the following criteria: American Society of Anesthesiologists physical status of 1 to 3, age between 18 and 80 years, and scheduled to undergo knee surgery that required a sciatic nerve block. The lower limbs of each patient were placed in the following 4 positions: N, neutral; ER, external rotation of the hip (angle, 45°); ER/F15, ER (angle, 45°) and flexion (angle, 15°) of the hip; and ER/F45, ER (angle, 45°) and F (angle, 45°) of the hip. An investigator acquired US scans of the sciatic nerve in each position, and the visibility score and depth of the sciatic nerve from the skin were analyzed. Results The visibility scores were significantly higher in positions ER/F15 and ER/F45 than in positions ER and N ( P < .0001). However, there was no difference between the visibility scores in positions ER/F15 and ER/F45 ( P = .0959). The depth of the sciatic nerve from the skin decreased with ER and an increase in the F angle of the hip (overall P < .0001). Conclusions Based on the visibility score and depth from the skin, ER of the hip to 45° with a greater F angle (45° versus 15°) of the hip appears to be the optimal position for an US‐guided anterior approach to a sciatic nerve block.