ABSTRACT
Clinical Applications The parasacral approach is the most proximal of the posterior approaches to the sciatic nerve. As a result, the posterior cutaneous nerve usually is blocked, and the gluteal, pudendal, and obturator nerves frequently are blocked. This approach has been used to provide analgesia after major knee, foot, and ankle reconstruction. For procedures above the knee, this approach may provide an advantage over more distal approaches to the sciatic nerve. However, for procedures below the knee, the adductor weakness (from obturator and superior gluteal nerve block) may be disadvantageous for mobilization of the patient.
