Proximal sciatic nerve blocks

Four main proximal techniques are suitable for approaching the sciatic nerve [48].

Posterior approach

The child is placed in the lateral decubitus position, resting on the non-operated side. The landmarks are the greater trochanter of the femur and the end of the coccyx (Figure 4). The site of puncture is the midpoint of the line joining the two landmarks. The block needle is inserted at right angles to the skin, i.e., both medially and ventrally, pointing to the ischial tuberosity, until twitches are elicited in the leg and/or the foot.





                       Figure 4. Proximal posterior approach to the sciatic nerve
                       1. Greater trochanter of the femur
                       2. Coccyx
                       3. Sciatic nerve
                       4. Site of puncture