US-Guided Popliteal Catheter Placed in the Long Axis
Popliteal & Other Sciatic Blocks • 14m
Dr. Stephen Anderson, an anesthesiologist with Northside Anesthesiology Consultants in Atlanta and former regional anesthesia fellow at the Andrews Institute, performs a popliteal sciatic catheter for postoperative pain control after major foot surgery. After noticing an increased incidence of internal catheter dislodgement with in-plane catheters placed in the short axis perpendicular to the nerve, Dr. Anderson helped develop an alternative approach. He first places a single injection popliteal sciatic block using the usual in-plane short-axis technique with an 8cm 22g block needle. This provides a dense primary block aided by his multiple injection technique, and also provides valuable contrast between the anechoic (black) local anesthetic and the echogenic (white) sciatic nerve. This 1st step can be very helpful as the long-axis view of the sciatic nerve can be quite difficult to maintain otherwise. He then rotates his ultrasound probe 90 degrees to achieve a long axis view of the sciatic nerve, and performs a long-axis, in-plane popliteal sciatic catheter parallel to the sciatic nerve. The goal is to leave ~5 cm of catheter parallel to the nerve so that leg movements (knee flexion/extension, foot dorsi/plantar flexion) do not displace the catheter internally.
Up Next in Popliteal & Other Sciatic Blocks
Optimizing Nerve & Needle Visualizati...
Dr. Scott Thomas, a former regional anesthesia fellow at the Andrews Institute, performs a popliteal sciatic block while focusing on the basic ultrasound probe maneuvers and needle manipulation tips used to optimize both target nerve and needle visualization.
US-Guided Tunneled Popliteal Catheter
Dr. Hickman, medical director at the Andrews Institute ASC, performs a continuous popliteal sciatic nerve block catheter with ultrasound guidance for major ankle surgery.
Supine Popliteal Block
Block of the Day #15: Greg Hickman performs a supine US-guided popliteal block at the Andrews Institute.