Contraindications

     •Contraindications are similar to those with other peripheral blocks: infection at the puncture
       point, coagulation disorders and neurological defects in the territories of the block
     •sacral decubitus
     •lack of patients cooperation
     •inability to assume the lateral decubitus position.

Conclusion

The parasacral approach to sciatic block is a technique well suited for anesthesia of the lower limb. It results in a high success rate and possibly less discomfort during the procedure than the posterior approach to the sciatic nerve block. Additionally, the extension of the block could be better than that of other approaches. When combined with a lumbar plexus block, this technique can be used to anesthetize the entire lower limb, including the posterior aspect of the knee. Finally, the open fascial plane facilitates insertion of an indwelling catheter for continuous infusion of local anesthetics.

Bibliography

1. Mansour NY. Reevaluating the sciatic nerve block: Another landmark for consideration. Reg Anesth 1993;18:322-3
2. Morris GF, Scott AL. Continuous parasacral sciatic nerve block: two case reports. Reg Anesth 1997;22:469-72
3. Dieteman JL, Sick H, Wolfram-Gabel R, Cruz da Silva R, Koritke JG, Wackenheim A.Anatomy and computed tomography of the normal lumbosacral plexus. Neuroradiology, 1987;29:58-68
4. Bruelle P, Cuvillon P, Ripart J, Eledjam JJ. Sciatic nerve block: Parasacral approach. Reg Anesth 1998;23:S78
5. Morris GF, Lang SC, Dust WN, Van der Wal M. The parasacral sciatic nerve block. Reg Anesth, 1997;22:223-8