Table 2

Important technical areas pertaining to lower extremity nerve blocks warranting further investigation with randomized controlled trials

Posterior approach for lumbar plexus block
  • Reliability of Dekrey’s and Capdevila’s landmarks for PNS guidance in pediatric patients

Femoral nerve block
  • Comparison between single-injection and multiple-injection PNS techniques for local anesthetic volumes greater than 12 mL

Obturator nerve block
  • Comparison between single LA injection between the pectineus and obturator externus muscles and separate LA injections between the adductor longus and brevis muscles and between the adductor brevis and magnus muscles

Sciatic nerve block
  • Comparison between the parasacral and the subgluteal/anterior/popliteal approaches to the sciatic nerve

  • Comparison between the transgluteal and the anterior/lateral mid-femoral approaches to the sciatic nerve

  • Comparison between the subgluteal and the lateral mid-femoral/lateral popliteal approaches to the sciatic nerve

  • Comparison between the anterior and the lateral popliteal/posterior popliteal approaches to the sciatic nerve

  • Comparison between approaches (other than transgluteal, lateral mid-femoral, and anterior) for pediatric patients

  • Optimal evoked motor response for methods other than the parasacral, transgluteal, and lateral popliteal approaches

  • Comparison of US and PNS for methods other than the subgluteal, lateral mid-femoral, and posterior popliteal approaches

  • Comparison of US and PNS for continuous sciatic catheters using methods other than the posterior popliteal approach

  • Further studies to validate the safety of intentional intraneural injection of the tibial and common peroneal nerves

  • LA, local anesthetic; PNS, peripheral nerve stimulation; US, ultrasound.