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Anterior access (based on Wiegel et al.)

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Another option which has proven useful for anterior sciatic nerve block in practice is the ‚Wiegel‘ technique. Accidental puncture of blood vessels is relatively rare with the anterior access variant described below.

Anatomic Landmarks

Femoral artery, patella (photo)

anterior ischiadicus wiegel

 

Block technique

The patient lies supine with the legs slightly apart in a neutral position. The potential puncture point for a classical femoral block is marked lateral to the femoral artery and ca. 2 cm under the inguinal ligament; another mark is made in the middle of the top patella border. These two guide points are then joined by drawing a straight line. About 5 cm along this line, distal to the femoral puncture point, is the location for applying the anterior sciatic nerve block. The direction of puncture must be quite vertical to the underlying surface, and is thus precisely defined.