Ultrasound guidance for difficult lateral popliteal catheter insertion in a patient with peripheral vascular disease.
OBJECTIVE
Interest in ultrasound-guided nerve block is increasing, but clinical utility still is being determined. We report a case in which ultrasound imaging aided nerve localization during popliteal block.


METHODS
We report a case in which failure of nerve stimulation to locate the sciatic nerve at the popliteal fossa in a patient with underlying neuropathy was overcome by ultrasound guidance, which allowed quick and easy catheter placement. After failure of the stimulation technique, ultrasound permitted us to observe advancement of the needle, placement of the catheter, and spread of local anesthetic around the nerve.


CONCLUSIONS
Ultrasound guidance can facilitate lateral popliteal catheter insertion in patients in whom electrolocation has failed.
Département d'Anesthésie-Réanimation, Hôpital de Bictêre, Le Kremlin-Bictêre, France.
Vincent
V
Minville
Paul Joseph
PJ
Zetlaoui
Christine
C
Fessenmeyer
Dan
D
Benhamou
D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization / Q000379:methods*; D004558:Electric Stimulation; D005528:Foot / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000150:complications; D007717:Knee / Q000000981:diagnostic imaging* / Q000294:innervation; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000150:complications*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D000077212:Ropivacaine; D012584:Sciatic Nerve / Q000000981:diagnostic imaging* / Q000187:drug effects; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine