Technical report on the new ultrasound lateral mid-shaft approach to the sciatic nerve: a never-ending story
Abstract
The anatomy of the sciatic nerve allows it to be blocked at different levels using various anesthetic approaches. However, for several reasons, performing these approaches may be challenging or disadvantageous in specific categories of patients, particularly in obese patients. The objective of this brief technical report is to describe a new technical approach to sciatic nerve block, designed to simplify the procedure for certain categories of patients and less experienced practitioners. Since 2010, more than 5000 procedures have been performed by both experienced anesthesiologists and novice trainees in several hospitals. The ultrasound lateral mid-shaft technique appears to be a safe and effective method for performing a sciatic nerve block, even in obese patients with significant subcutaneous fat and unclear ultrasound images. This approach is particularly beneficial given the various anatomical variations that can occur. By targeting the mid-thigh area, the ultrasound beam accesses anatomical structures that are more superficial, improving the technique's efficacy. Various hospital groups have been performing this technique as a routine procedure, achieving a success rate of nearly 100%. This impressive success rate exceeds that of other conventional techniques documented in the literature. Additionally, there have been significant improvements in comfort and ease for anesthetists. This method allows the anesthetic to spread around the paraneural sheath, covering the posterior femoral cutaneous nerve. Finally, it is performed in the supine position without the need to mobilize the lower limbs, ensuring patient comfort, especially in cases of fractures or lower limb injuries. Further studies are needed to confirm these results.
Author
Sepolvere, Giuseppe
Tedesco, Mario
Cibelli, Mario
Cirillo, Dario
Sparaco, Angelo
Gagliardi, Giuseppe
Costagliola, Giuseppina
Cristiano, Loredana
Scialdone, Valeria Rita
Pasquariello, Maria Rosaria
Di Zazzo, Fabrizio
Merola, Luigi
Della Valle, Mirco
Arminio, Daniela
Bottazzo, Leonardo Maria
Folliero, Marco
Ranieri, Giorgio
Santonastaso, Domenico Pietro
Coviello, Antonio
Tedesco, Mario
Cibelli, Mario
Cirillo, Dario
Sparaco, Angelo
Gagliardi, Giuseppe
Costagliola, Giuseppina
Cristiano, Loredana
Scialdone, Valeria Rita
Pasquariello, Maria Rosaria
Di Zazzo, Fabrizio
Merola, Luigi
Della Valle, Mirco
Arminio, Daniela
Bottazzo, Leonardo Maria
Folliero, Marco
Ranieri, Giorgio
Santonastaso, Domenico Pietro
Coviello, Antonio
Date
2025-01-10
Type
Article
Subject
Surgery::Anaesthesia, Surgery, Human anatomy
Collections
Citation
Sepolvere G, Tedesco M, Cibelli M, Cirillo D, Sparaco A, Gagliardi G, Costagliola G, Cristiano L, Scialdone VR, Pasquariello MR, Di Zazzo F, Merola L, Della Valle M, Arminio D, Bottazzo LM, Folliero M, Ranieri G, Santonastaso DP, Coviello A. Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story. Medicina (Kaunas). 2025 Jan 10;61(1):100. doi: 10.3390/medicina61010100.
Journal / Source Title
Medicina
DOI
10.3390/medicina61010100
PMID
39859082
Publisher
MDPI
Publisher’s URL
http://www.mdpi.com/journal/medicina
https://pmc.ncbi.nlm.nih.gov/journals/?term=9425208
https://pmc.ncbi.nlm.nih.gov/journals/?term=9425208