Lower extremity regional anesthesia with the low sciatic nerve block.

Regional anesthesia with local anesthetics is an important component of the perioperative pain management algorithm in the context of lower extremity orthopedic surgery. These techniques have proved to be consistent and effective in minimizing postoperative pain and narcotic usage, and in reducing the morbidity associated with lower extremity surgery. The mechanisms of local anesthetic agents as they relate to acute surgical pain are reviewed in this article, with an emphasis on the low sciatic nerve block. Administration techniques and the clinical experience of the author with this blockade are discussed.