Department of Anesthesiology and Intensive Care, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu.
Kathmandu Univ Med J (KUMJ). 2020 Apr-Jun;18(70):176-180.
Background Sciatic nerve block used for various surgeries below knee and for maintenance of analgesia demonstrates wide variability regarding its bifurcation into tibial and common peroneal nerves, frequently accounting for incomplete nerve blocks. Objective To determine the variation of sciatic nerve bifurcation among Nepalese volunteers. Method This cross sectional study was conducted in the Department of Anesthesiology of Kathmandu Medical College Teaching Hospital from March to May 2019, where 110 healthy volunteers underwent ultrasonography of sciatic nerve starting from popliteal fossa to its bifurcation. The distance between the bifurcation of sciatic nerve from popliteal crease and depth of the nerve at that point from the skin were measured. Result The mean distance at which sciatic nerve bifurcated from the popliteal crease was 5.42 ± 1.37 cm. Most commonly, the sciatic nerve bifurcated at a distance of 5-7 cm from the popliteal crease in 110 limbs (50.45%). However, in 80 limbs (36.69%), the bifurcation was found at less than 5 cm from the popliteal crease. The depth of the nerve from the skin at the point of bifurcation was 1.72 ± 0.54 cm, with results showing it was deeper in females compared to males (p value < 0.001). Conclusion This study showed that though the distance of sciatic nerve bifurcation from the popliteal crease in our study group was coherent with the published literature of 5-12 cm; many volunteers also had this bifurcation at distances less than 5 cm. Females showed nerves to be deeper at the point of bifurcation than males.
用于膝下各种手术和维持镇痛的坐骨神经阻滞，其在分为胫神经和腓总神经时存在很大的变异性，这常常导致不完全的神经阻滞。目的：确定尼泊尔志愿者坐骨神经分叉的变异情况。方法：这是一项横断面研究，于 2019 年 3 月至 5 月在加德满都医学院教学医院麻醉科进行，有 110 名健康志愿者接受了从腘窝到坐骨神经分叉处的超声检查。测量坐骨神经分叉处距腘窝皱襞的距离和该点处神经的深度。结果：坐骨神经从腘窝皱襞分叉的平均距离为 5.42 ± 1.37cm。最常见的是，110 条肢体（50.45%）的坐骨神经在距腘窝皱襞 5-7cm 的位置分叉。然而，在 80 条肢体（36.69%）中，分叉发生在距腘窝皱襞小于 5cm 的位置。分叉处神经距皮肤的深度为 1.72 ± 0.54cm，结果显示女性比男性更深（p 值<0.001）。结论：本研究表明，尽管我们研究组坐骨神经从腘窝皱襞的分叉距离与已发表的文献 5-12cm 一致，但许多志愿者的分叉距离也小于 5cm。女性在分叉处的神经比男性更深。
