Ultrasound Guided Nerve Blocks for Lower Extremity

Branches of the lumbosacral plexus innervate the entire lower extremity and targeting any one or more of these can be of great clinical benefit. These branches include the femoral (L2-4), lateral femoral cutaneous (L1-3), posterior femoral cutaneous (S1-3), obturator (L2-4), and sciatic (L4-5, S1-4) nerves. Finding ways to safely localize these nerves can provide significant relief for surgical pain or many other acute and chronic pain syndromes. Landmark based techniques for lower extremity nerve blocks were the standard for many years and are well described in the literature. The introduction of ultrasound has afforded opportunities to improve on these techniques with direct visualization, both improving efficacy and reducing complications. A successful nerve block can reduce the need for excessive intravenous or oral pain medication, reducing side effects and potentially even length of stay following painful surgical procedures. Further improving the current techniques, as well as researching new approaches, will be important for the advancement of the field of regional anesthesia and its many clinical benefits.