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Regional anesthesia and acute pain: Brief technical report
Ultrasound Detection of Arteria Comitans: A Novel Technique to Locate the Sciatic Nerve
  1. Hesham Elsharkawy, MD, MSc*,
  2. Babak Kateby Kashy, MD†,‡,
  3. Rovnat Babazade, MD‡,§ and
  4. Andrew T. Gray, MD, PhD∥
  1. *Department of Anesthesiology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland Clinic, Cleveland, OH
  2. †Senior Care Physicians, Taylor, MI
  3. ‡Outcomes Research Consortium, Cleveland, OH
  4. §Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX
  5. ∥Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
  1. Address correspondence to: Hesham Elsharkawy, MD, MSc, Assistant Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Ave, E-31, Cleveland, OH, 44195 (e-mail: elsharh{at}ccf.org).

Abstract

Abstract In the gluteal and thigh region, the arteria comitans accompanies the sciatic nerve for a short distance, then penetrates the nerve and runs to the lower part of the thigh. There is no study that recognizes this artery as a guide to the location of the sciatic nerve. In this report, we describe a series of 6 knee arthroplasty patients in whom ultrasound-guided sciatic nerve block was successfully performed using color Doppler and pulsed wave Doppler to visualize the arteria comitans as a guide to the location of the sciatic nerve. We have found that detecting the arteria comitans as a landmark is novel and may offer an additional tool with the existing methods for sciatic nerve block.

https://doi.org/10.1097/AAP.0000000000000665

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    Footnotes

    • Permission to use images was obtained from the Cleveland Clinic Department of Photography.

      The authors declare no conflict of interest.

      No external funding was provided.

      Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.rapm.org).