BoardsBridgePopliteal Sciatic Nerve Block
Ultrasound-guided sciatic blockade in the popliteal fossa for foot and ankle anesthesia and analgesia; pair with a saphenous block for complete lower-leg coverage
The popliteal sciatic block is an ultrasound-guided regional technique depositing local anesthetic around the sciatic nerve in the popliteal fossa (proximal to or at its tibial/common peroneal bifurcation) to provide anesthesia and analgesia for foot and ankle surgery; it does not cover the medial leg, which requires an additional saphenous (femoral) block.
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HEADLINE: Popliteal sciatic block = US-guided LA around the sciatic nerve in the popliteal fossa; covers most of the leg and foot EXCEPT the medial saphenous distribution.
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Key numbers
- 0.1-0.25% — bupivacaine, levobupivacaine, or ropivacaine concentration range for single-shot blocks in children at risk for compartment syndrome (ESRA/ASRA 2018); restrict both volume and concentration for sciatic catheters.
- 4 of 5 — number of foot-innervating nerves that are sciatic terminal branches (tibial, sural, deep peroneal, superficial peroneal); the saphenous is the lone femoral branch (Miller Ch 42)
- 2 joints — the sciatic nerve and its branches cross BOTH the hip and the knee; assess flex/extension at both joints when positioning to prevent stretch neuropathy (Miller Ch 30)
Uri Rozen, MD — Licensed Physician, Israel
Source guidelines: Millers Anesthesia 10 Ch42 Peripheral Nerve Blocks AND Ultrasound Guidance FOR Regional · ESRA ASRA Pediatric Controversial 2018 · Millers Anesthesia 10 Ch60 Anesthesia FOR Orthopedic Surgery · Millers Anesthesia 10 Ch74 Regional Anesthesia IN Children
Re-review cadence: 12 months from reviewed date.
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Card ID: popliteal-sciatic · Path: aba.regional.lower-extremity.popliteal-sciatic