Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story
The anatomy of the sciatic nerve allows it to be blocked at different levels using various anesthetic approaches. However, for several reasons, performing these approaches may be challenging or disadvantageous in specific categories of patients, particularly in obese patients. The objective of this...
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MDPI AG
2025-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/61/1/100 |
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| author | Giuseppe Sepolvere Mario Tedesco Mario Cibelli Dario Cirillo Angelo Sparaco Giuseppe Gagliardi Giuseppina Costagliola Loredana Cristiano Valeria Rita Scialdone Maria Rosaria Pasquariello Fabrizio Di Zazzo Luigi Merola Mirco Della Valle Daniela Arminio Leonardo Maria Bottazzo Marco Folliero Giorgio Ranieri Domenico Pietro Santonastaso Antonio Coviello |
| author_facet | Giuseppe Sepolvere Mario Tedesco Mario Cibelli Dario Cirillo Angelo Sparaco Giuseppe Gagliardi Giuseppina Costagliola Loredana Cristiano Valeria Rita Scialdone Maria Rosaria Pasquariello Fabrizio Di Zazzo Luigi Merola Mirco Della Valle Daniela Arminio Leonardo Maria Bottazzo Marco Folliero Giorgio Ranieri Domenico Pietro Santonastaso Antonio Coviello |
| author_sort | Giuseppe Sepolvere |
| collection | DOAJ |
| description | The anatomy of the sciatic nerve allows it to be blocked at different levels using various anesthetic approaches. However, for several reasons, performing these approaches may be challenging or disadvantageous in specific categories of patients, particularly in obese patients. The objective of this brief technical report is to describe a new technical approach to sciatic nerve block, designed to simplify the procedure for certain categories of patients and less experienced practitioners. Since 2010, more than 5000 procedures have been performed by both experienced anesthesiologists and novice trainees in several hospitals. The ultrasound lateral mid-shaft technique appears to be a safe and effective method for performing a sciatic nerve block, even in obese patients with significant subcutaneous fat and unclear ultrasound images. This approach is particularly beneficial given the various anatomical variations that can occur. By targeting the mid-thigh area, the ultrasound beam accesses anatomical structures that are more superficial, improving the technique’s efficacy. Various hospital groups have been performing this technique as a routine procedure, achieving a success rate of nearly 100%. This impressive success rate exceeds that of other conventional techniques documented in the literature. Additionally, there have been significant improvements in comfort and ease for anesthetists. This method allows the anesthetic to spread around the paraneural sheath, covering the posterior femoral cutaneous nerve. Finally, it is performed in the supine position without the need to mobilize the lower limbs, ensuring patient comfort, especially in cases of fractures or lower limb injuries. Further studies are needed to confirm these results. |
| format | Article |
| id | doaj-art-0cc9632a2f55418a80cb4082919f26d5 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-0cc9632a2f55418a80cb4082919f26d52025-01-24T13:40:36ZengMDPI AGMedicina1010-660X1648-91442025-01-0161110010.3390/medicina61010100Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending StoryGiuseppe Sepolvere0Mario Tedesco1Mario Cibelli2Dario Cirillo3Angelo Sparaco4Giuseppe Gagliardi5Giuseppina Costagliola6Loredana Cristiano7Valeria Rita Scialdone8Maria Rosaria Pasquariello9Fabrizio Di Zazzo10Luigi Merola11Mirco Della Valle12Daniela Arminio13Leonardo Maria Bottazzo14Marco Folliero15Giorgio Ranieri16Domenico Pietro Santonastaso17Antonio Coviello18Department of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, Mater Dei Hospital, 70125 Bari, ItalyDepartment of Anaesthesia and Critical Care Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UKDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyDepartment of Anaesthesia, S. Michele Hospital, 81024 Maddaloni, ItalyComplex Operational Unit of Anesthesia and Operating Units, Department of Emergency and Internal Medicine, Isola Tiberina Hospital, Gemelli Isola, 00186 Rome, ItalyAnesthesia and Intensive Care Unit, AUSL Romagna, M. Bufalini Hospital, 47521 Cesena, ItalyDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, ItalyThe anatomy of the sciatic nerve allows it to be blocked at different levels using various anesthetic approaches. However, for several reasons, performing these approaches may be challenging or disadvantageous in specific categories of patients, particularly in obese patients. The objective of this brief technical report is to describe a new technical approach to sciatic nerve block, designed to simplify the procedure for certain categories of patients and less experienced practitioners. Since 2010, more than 5000 procedures have been performed by both experienced anesthesiologists and novice trainees in several hospitals. The ultrasound lateral mid-shaft technique appears to be a safe and effective method for performing a sciatic nerve block, even in obese patients with significant subcutaneous fat and unclear ultrasound images. This approach is particularly beneficial given the various anatomical variations that can occur. By targeting the mid-thigh area, the ultrasound beam accesses anatomical structures that are more superficial, improving the technique’s efficacy. Various hospital groups have been performing this technique as a routine procedure, achieving a success rate of nearly 100%. This impressive success rate exceeds that of other conventional techniques documented in the literature. Additionally, there have been significant improvements in comfort and ease for anesthetists. This method allows the anesthetic to spread around the paraneural sheath, covering the posterior femoral cutaneous nerve. Finally, it is performed in the supine position without the need to mobilize the lower limbs, ensuring patient comfort, especially in cases of fractures or lower limb injuries. Further studies are needed to confirm these results.https://www.mdpi.com/1648-9144/61/1/100loco-regional anesthesianerve blocksciatic nervelower limb |
| spellingShingle | Giuseppe Sepolvere Mario Tedesco Mario Cibelli Dario Cirillo Angelo Sparaco Giuseppe Gagliardi Giuseppina Costagliola Loredana Cristiano Valeria Rita Scialdone Maria Rosaria Pasquariello Fabrizio Di Zazzo Luigi Merola Mirco Della Valle Daniela Arminio Leonardo Maria Bottazzo Marco Folliero Giorgio Ranieri Domenico Pietro Santonastaso Antonio Coviello Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story Medicina loco-regional anesthesia nerve block sciatic nerve lower limb |
| title | Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story |
| title_full | Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story |
| title_fullStr | Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story |
| title_full_unstemmed | Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story |
| title_short | Technical Report on the New Ultrasound Lateral Mid-Shaft Approach to the Sciatic Nerve: A Never-Ending Story |
| title_sort | technical report on the new ultrasound lateral mid shaft approach to the sciatic nerve a never ending story |
| topic | loco-regional anesthesia nerve block sciatic nerve lower limb |
| url | https://www.mdpi.com/1648-9144/61/1/100 |
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