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PEDIATRIC ANESTHESIA

Ultrasound-Guided Subgluteal Sciatic Nerve Blocks with Stimulating Catheters in Children: A Descriptive Study

From the Institute for Anesthesiology, Medical Centre, Radboud University, Nijmegen, the Netherlands.

Address correspondence and reprint requests to Geert Jan van Geffen, MD, Radboud University, Medical Centre, Institute for Anesthesiology, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Address e-mail to G.vanGeffen{at}anes.umcn.nl.

We describe our clinical experience of combining ultrasound guidance and nerve stimulation for the insertion of subgluteal sciatic catheters in children. Ten children scheduled for lower limb surgery with a combined general anesthetic and a subgluteal sciatic catheter placement for both operative anesthesia and postoperative pain relief were studied. Under ultrasonographic guidance the sciatic catheter was placed using an 17-gauge 50-mm Arrow® continuous peripheral nerve block needle and a 19-gauge stimulating catheter (Stimucath®). The minimal electrical current required for muscle contraction on the stimulating needle and catheter differed widely among patients. Based on the visualization of the spread of local anesthetic during injection through the catheter, a successful prediction for the sciatic block was made in all patients. All catheters were successfully placed and provided excellent postoperative pain relief without complications.

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