Ultrasound-guided sciatic nerve block: An educational review of anatomy and techniques – Part A: Proximal approaches

The sciatic nerve block is a cornerstone of regional anaesthesia for lower limb surgeries, providing effective analgesia and anaesthesia. This narrative review explores the ultrasound-guided sciatic nerve block at proximal levels, emphasising anatomical considerations, sonoanatomy, and various approaches. A detailed understanding of the sciatic nerve's course and surrounding anatomy at different levels enables practitioners to select the most appropriate technique for optimal outcomes. This article, Part A, focuses on proximal approaches, discussing their advantages, technical nuances, and clinical applications. Dual guidance, which combines ultrasound and peripheral nerve stimulation, is emphasised for improved accuracy, safety, and enhanced success rates. High-resolution ultrasound imaging enhances precision, minimises complications, and ensures precise deposition of local anaesthetic. In the subsequent article (Part B), we will delve into the sciatic nerve block approaches at distal levels, completing a comprehensive guide to ultrasound-guided sciatic nerve blockade. This review aims to serve as a valuable, updated resource for regional anaesthesia enthusiasts and trainees seeking to enhance their knowledge and clinical expertise.