Indications

Surgery

Common indications for use of parasacral sciatic nerve block for surgery include knee, leg and foot surgery, or as a supplement to femoral nerve block.

Pain Management

Postoperative pain management after knee, leg or foot surgery.
The facility of insertion of a catheter in the space formed by the pelvic fascia medially, piriformis muscle dorsally, obturator internus laterally allows a good prolonged analgesia in the surgery of the lower limb.

The continuous parasacral sciatic block is indicated in the proximal surgery, where the posterior cutaneous nerve of the thigh is concerned:

     •carcinologic surgery of the lower limb
     •thigh or leg amputation
     •popliteal fossea surgery (tumors, cysts...)
     •total knee arthroplasty
 
Other indications are prolonged ankle, leg or foot surgery with a thigh tourniquet (serious trauma or microsurgery): in these indications the catheter technique is not only beneficial for the pain but by the prolonged sympathetic block as well.

Introduction

Anatomy

Equipment

Positioning

Landmarks

Needle Orientation

Stimulation

Stimulation Tips

Extension of the Parasacral Block

Anesthetics

Indications

Contra-indications

Conclusion

Bibliography