Both extraneuronal and intraneuronal sciatic nerve blocks at the popliteal fossa have been shown to be effective and to be associated with a small incidence of neuronal injury. In this issue of Anesthesiology, Cappelleri et al. performed intraneuronal sciatic nerve blocks to determine the lowest effective local anesthetic dose and conducted follow-up clinical and neurophysiologic studies for 6 months. While intraneuronal injection produced reliable sciatic nerve blockade using small local anesthetic volumes, neurophysiologic changes persisted at 6 months, suggesting persistent neuronal injury. In an accompanying Editorial View, Vlassakov et al. question the wisdom of intentional intraneuronal injection as a strategy for reducing local anesthetic dose. Illustration by Annemarie Johnson, Vivo Visuals.

  • Cappelleri et al.: Intraneural Ultrasound-guided Sciatic Nerve Block: Minimum Effective Volume and Electrophysiologic Effects, p. 241

  • Vlassakov et al.: Intraneural Injection: Is the Jury Still Out? p. 221