LKnative – Subgluteal sciatic nerve block

Indications of proximal sciatic nerve blocks

Proximal sciatic nerve block is indicated:

– for surgical anaesthesia with peripheral nerve blocks that includes surgery of the thigh or knee

– for surgical anaesthesia with peripheral nerve blocks that includes a thigh tourniquet

– as an alternative to popliteal sciatic nerve block when that is not feasible

Proximal sciatic nerve blocks are:

– the subgluteal approach

– the anterior approach combined with a saphenous nerve block (SPEDI)

– the parasacral parallel shift approach to block the sacral plexus (as an alternative to subgluteal approach or
SPEDI – single penetration dual injection)

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Anatomy of the sciatic nerve in the subgluteal space

In the subgluteal space the sciatic nerve is sandwiched between the adductor magnus anteriorly and the hamstrings (long head of the biceps femoris laterally and the semitendinosus/semimembranosus medially).