Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks

Table 1 Overview of block characteristics

Block	Landmarks	Ultrasound guidance	Catheter technique	Benefits
Lumbar plexus block	Spinous process iliac crest (L4) needle insertion 4 cm from midline	Paramedian sagittal L3-L5 identification of psoas muscle needle insertion 4cm from midline	Not widely used not practical	Some evidence for benefit in regard of early recovery and opioid consumption
Femoral nerve block	Inguinal ligament inguinal crease femoral artery	Transverse direction femoral crease identification of femoral artery and femoral nerve	Superior to single shot after 24 h	Easy to learn safe to use
Saphenous nerve block	United States guidance preferred	Midthigh identifying sartorius muscle anteromedial to femoral artery		Easy to learn safe to use
Sciatic nerve block	Classic approach: greater trochanter posterior superior iliac spine needle insertion 4 cm distal to the mid of the drawn line	Anterior approach: proximal end of medial thigh nerve beneath aducctor magnus muscle and femur	FNB catheter neccesary classic approach not well suited for catheters	Classic approach - easy to perform - high success rate