Ultrasound guidance for difficult lateral popliteal catheter insertion in a patient with peripheral vascular disease.

Abstract

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. 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. Ultrasound guidance can facilitate lateral popliteal catheter insertion in patients in whom electrolocation has failed.