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Sciatic nerve block

机译：坐骨神经阻滞

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摘要

The sciatic nerve is located deeply, is complex in its conformation, and is the largest single nerve of the body. Multiple and varied approaches are described for its blockade. It is preferably performed with a peripheral nerve stimulator seeking an adequate muscular response. The block is usually easily and quickly performed, with few complications. It is indicated for pre- or postoperative analgesia either in single dose or with catheter, or for anesthesia of the posterior and inferior regions of the entire leg and foot; in trauma, orthopedics, vascular surgery and radiological procedures, alone or associated with blockades of other nerves. In this review we focused on the relevant anatomic landmarks for each approach and their specific indications. Sciatic blocks have the slowest onset and longest duration compared to other peripheral nerve blocks. In our daily practice, we have adopted the parasacral approach described by Mansour, that allows not only blockade of the major and lesser sciatic nerves but of the obturator nerve as well. It is the most proximal technique of sciatic nerve blockade described and it is in fact a true plexus blockade of the entire sacral plexus. In combination with a femoral blockade, sciatic nerve block gives anesthesia and analgesia to the entire lower extremity unilaterally.
机译：坐骨神经位置深，构象复杂，是人体最大的单个神经。针对其封锁描述了多种多样的方法。优选用寻求适当肌肉反应的周围神经刺激器进行。该阻滞通常很容易快速地完成，几乎没有并发症。它适用于单剂量或带导管的术前或术后镇痛，或用于整个腿和脚后部和下部区域的麻醉。单独或与其他神经阻滞相关的创伤，骨科，血管外科手术和放射学程序。在这篇综述中，我们重点介绍了每种方法的相关解剖标志及其具体适应症。与其他周围神经阻滞相比，坐骨神经阻滞起病最慢，持续时间最长。在我们的日常实践中，我们采用了曼苏尔（Mansour）描述的s旁方法，该方法不仅可以阻断主要和较小的坐骨神经，还可以阻断闭孔神经。它是所描述的最接近的坐骨神经阻滞技术，实际上它是对整个神经丛的真正的神经丛阻滞。结合股骨阻滞，坐骨神经阻滞可单侧对整个下肢进行麻醉和镇痛。

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