A new two in one approach to ultrasound guided anterior sciatic and adductor canal block for below knee surgeries

• Author Details:   
• Prashanth Gowtham Raj S K ^*
• Kaggathi Ramesh Vasantha Kumar
• Ashiq Muhammed

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Background and Aims: Sciatic and saphenous nerve blocks are commonly performed at the midthigh level under ultrasound guidance, typically requiring two separate skin entry points. This traditional approach may increase procedural complexity and patient discomfort. This study evaluated a two-in-one technique to perform anterior sciatic and saphenous nerve blocks through a single skin puncture at the midthigh level, aiming to simplify the procedure. The primary objective was to assess the feasibility, clinical utility, and safety of this technique, while secondary objectives included evaluating procedural time, sensory and motor block onset, and the duration of postoperative analgesia.

Materials and Methods: The study included 60 patients aged 18 to 80 years, of either sex, with ASA status I-III, undergoing elective or emergency below-knee surgeries. The blocks were performed under ultrasound guidance, and procedural time, sensory and motor block onset, and duration of postoperative analgesia were recorded.

Results: The two-in-one technique was successfully performed in all patients with a single skin puncture. The mean procedural time was 11.4 ± 0.632 minutes. The average onset times for sensory and motor blocks were 6.8 ± 0.748 minutes and 11.6 ± 0.894 minutes, respectively. The mean duration of postoperative analgesia was 13 ± 0.748 hours.

Conclusion: This novel ultrasound-guided approach to anterior sciatic and adductor canal block at the midthigh level using a single skin puncture is a safe, reproducible, and clinically effective technique for achieving complete anesthesia for below-knee surgeries.

Keywords: Anterior sciatic block, Adductor canal block, Below-knee surgeries, Ultrasound-guided blocks.