Hindlimb unilateral Parasacral Sciatic Nerve Block

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B. Braun Vet Care
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Anesthesia
Regional Anesthesia
Peripheral Nerve Block
Parasacral Sciatic Nerve Block

Indication

Anesthesia of the ipsilateral hindlimb including the hemipelvis and the hip joint (in combination with psoas compartment block)

Step by step

Lateral position, limb to be blocked on top
Sciatic nerve (yellow), A. glutaea caudalis (red), V. glutaea caudalis (blue)
Line connecting the cranial iliac crest and the medial sciatic tuberosity
Needle insertion at the border of the cranial to middle third of the auxiliary line perpendicular to the skin surface, A. and V. glutaea caudalis (blue/red)
Arrow = direction of needle insertion
Lateral position, limb to be blocked on top
Sciatic nerve (yellow), A. glutaea caudalis (red), V. glutaea caudalis (blue)
Line connecting the cranial iliac crest and the medial sciatic tuberosity
Needle insertion at the border of the cranial to middle third of the auxiliary line perpendicular to the skin surface, A. and V. glutaea caudalis (blue/red)
Arrow = direction of needle insertion

Local anesthetics

Correct needle position, sciatic nerve
Parasacral sciatic serve block (Nerve stimulation)

Local anesthetics: Lidocain 2%, Mepivacain 2%, Bupivacain 0.5%, Ropivacain 0.75%
Initial setting NS: 0.5-1.0 mA, 2 Hz, 0.10 ms
Needle orientation: needle insertion at the border of the cranial to middle third of the auxiliary line perpendicular to the skin
Muscle contraction: tarsus flexion
Reduction of the amperage: in small increments to <0.5 mA
Correction of the needle position: minor corrections only, start by bone contact on the ilium for orientation
MSC control: to avoid block failure
Aspiration and injection: slowly, Raj test, BSmart
Injection volume: 0.1 ml/kg
(Portela et al. 2010)

Videos

  • Parasacral sciatic serve block (Nerve stimulation)

    Incorrect muscle response (M. biceps femoris)

  • Parasacral sciatic serve block (Nerve stimulation)

    Correct muscle response (Cranial tibial muscle)

With the friendly assistance of
https://ktpraxis-berlin.de
Dr. Georg Papadopoulos
Veterinary Specialist for Small Animals
Additional Certification: Anesthesia in Small Animals
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Disclaimer

As with any intervention in the body, peripheral nerve blocks also carry the risk of complications. The presented procedures and dosages are thoroughly reviewed and based on currently available scientific data and clinical experience but should only be considered as guidelines along the contents of the course. The responsibility for performing the nerve blocks shown on this site as part of any anesthesia regimen or pain management lies with the executing clinician. B. Braun Vet Care GmbH and Dr. Papadopoulos cannot be held responsible for any complications or adverse effects, that may arise from the described techniques or for any mistakes in the information provided.