Background and Objectives Successful performance of lower-extremity regional anesthesia includes sensory and/or motor block assessment of up to 4 major peripheral nerves. This brief report describes a methodology for the rapid evaluation of lower-extremity anesthesia before surgical incision.

Methods Illustrations highlight the techniques for evaluation of sciatic, obturator, lateral femoral cutaneous, and femoral nerve anesthesia. This methodology is based on a Four P’s acronym: push, pull, pinch, punt.

Conclusions Accurate assessment of lower-extremity regional anesthesia can be achieved rapidly using The Four Ps evaluation tool.