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Anesth Analg 2004;98:1785-1788
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000117224.99190.A8

REGIONAL ANESTHESIA

Anterior Approach to the Sciatic Nerve Block: Adaptation to the Patient’s Height

Carole Barbero, MD, Régis Fuzier, MD, and Kamran Samii, MD

Service d’Anesthésie Réanimation, Chu Rangueil, Cedex, France

Address correspondence and reprint requests to Carole Barbero, MD, Service d’Anesthésie Réanimation, Chu Rangueil, 31 403 Toulouse, Cedex 04, France. Address e-mail to barbero.c{at}chu-toulouse.fr

To improve the incidence of block of the posterior femoral cutaneous nerve (PFCN) when using an anterior approach as described recently, we hypothesized that the distance between the inguinal line and the puncture site depends on the patient’s height. A preliminary radiological study performed in 13 patients established a formula describing the relationships between the patient’s height and the puncture site "S." A line was drawn between the anterior iliac spine and the superior angle of the pubic tubercle (inguinal line) and another line from the midpoint of the inguinal line to the puncture site "S." "S" was calculated from the midpoint of the inguinal line as "S" = (height in cm – 100)/10. A prospective study was conducted in 53 patients. Results are presented as median (range, 0.25–0.75). Two minutes were required to locate the sciatic nerve at a depth of 12 cm (10.5–13.0 cm). Complete sciatic and PFCN blocks were observed in 92% of the patients. We conclude that consideration should be given to the patient’s height when the sciatic nerve is blocked using an anterior approach. This technique seems to improve the success of block of the PFCN, essential to tolerate a thigh tourniquet.

IMPLICATIONS: This prospective but noncomparative work was performed to evaluate a new anterior technique of sciatic block, an adaptation of the anatomic landmarks described by Chelly and Delaunay, to patient height.




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 Anesth. Analg.Home page
R. Fuzier, P. Hoffreumont, S. Bringuier-Branchereau, X. Capdevila, and F. Singelyn
Does the Sciatic Nerve Approach Influence Thigh Tourniquet Tolerance During Below-Knee Surgery?
Anesth. Analg., May 1, 2005; 100(5): 1511 - 1514.
[Abstract] [Full Text] [PDF]

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 Anesth. Analg.Home page
J. E. Chelly and L. Delaunay
Block of the Posterior Femoral Cutaneous Nerve
Anesth. Analg., February 1, 2005; 100(2): 597 - 597.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.