For the posterior transgluteal sciatic block, place the patient in the lateral decubitus position with the extremity flexed at the hip and knee (Sims' position).
- Ultrasound-guided block – Place the ultrasound transducer midway between the greater trochanter and the sacral hiatus, oriented perpendicular to the axis of the femur.
- Nerve stimulator-guided block – Draw a line between the greater trochanter and the PSIS (line 1) and another between the greater trochanter and the sacral hiatus (line 3). Draw a perpendicular line between the midpoint of line 1 and where it intersects line 3 (line 2). Insert the needle at the intersection of lines 2 and 3.
This graphic shows the landmarks and marking for the Winnie modification of the approach of Labat for sciatic nerve block. For further details, refer to UpToDate content on transgluteal sciatic nerve block.
