Nerve Block Gallery - Transgluteal (Proximal) Sciatic Nerve Block
Caption
A 36-year-old male presented to the ED with acute onset left sided back pain that started suddenly 6 hours prior to arrival while bending over. The pain radiated down his left leg and he had a positive straight leg raise with a severely antalgic gait. A transgluteal sciatic nerve block was performed. The patient was positioned in the right lateral decubitus position with the left hip and knee flexed. The needle can be seen approaching from lateral to medial, just over the greater trochanter. The needle reaches the fascial plane between the gluteus maximus and quadratus femoris muscles where the sciatic nerve and inferior gluteal artery lie. The plane is seen separating with hydrodissection using 20 cc of 0.5% bupivacaine with 10 mg of dexamethasone. The patient had complete relief after the block and was able to ambulate out of the department with ease. Dr. Kate Simeon, PGY-4, Denver Health Emergency Medicine Residency Dr. Fred Milgrim, Ultrasound Fellow, Denver Health Emergency Medicine