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The lumbar plexus is formed by the loops of communication between the anterior roots of the first three lumbar nerves, the greater part of the fourth nerve fibers, and, in as many as 50% of cases, by a branch from T12; occasionally, a contribution by L5 is possible. The lumbosacral plexus divides into the femoral, lateral femoral cutaneous, obturator, and sciatic nerves that innervate the entire lower extremity. The femoral nerve provides sensation and motor function to the anterior thigh. The femoral nerve continues as the saphenous nerve, providing sensation to the ipsilateral medial leg and foot and a portion of the ipsilateral great toe. The LFCN supplies sensation to the lateral thigh. The sensory component of the obturator nerve supplies the medial thigh; the motor component supplies the thigh adductors. Neither the lateral femoral cutaneous nor the obturator nerve has any sensory or motor input to the leg distal to the knee. The sciatic nerve runs with the posterior cutaneous nerve of the thigh and provides sensory and motor innervation to the posterior thigh. The sciatic nerve continues posteriorly and divides into the tibial and common peroneal nerves, just cephalad to the popliteal fossa, and provides sensory and motor innervation to the anterior, lateral, and posterior lower leg. Five nerves provide sensory and motor function to the foot. The saphenous nerve supplies sensation to the medial foot and a portion of the great toe. The deep peroneal nerve supplies the web space between the great and second toes. The superficial peroneal nerve supplies most of the dorsum of the foot and toes, while the sural nerve supplies the lateral foot and a portion of the fifth toe. The posterior tibial nerve divides into the medial and lateral plantar nerves and supplies the sole and plantar surface of the toes (Tran et al., Reg Anesth Pain Med, 2019). All of these nerves and plexuses are potentially targeted by a US-guided needle, in order to deliver a planned mixture of anesthetic solution, to achieve an anesthetic or prolonged analgesic effect on the surgically treated body segment (Crutchfield et al., Am J Sports Med 51:279–297, 2023).

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Common Nerve Blocks of the Lower Limb

  • 章节

  • 发表日期：

    2026年

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  • Daniele Genco,
  • Paolo Grossi

摘要

The lumbar plexus is formed by the loops of communication between the anterior roots of the first three lumbar nerves, the greater part of the fourth nerve fibers, and, in as many as 50% of cases, by a branch from T12; occasionally, a contribution by L5 is possible. The lumbosacral plexus divides into the femoral, lateral femoral cutaneous, obturator, and sciatic nerves that innervate the entire lower extremity. The femoral nerve provides sensation and motor function to the anterior thigh. The femoral nerve continues as the saphenous nerve, providing sensation to the ipsilateral medial leg and foot and a portion of the ipsilateral great toe. The LFCN supplies sensation to the lateral thigh. The sensory component of the obturator nerve supplies the medial thigh; the motor component supplies the thigh adductors. Neither the lateral femoral cutaneous nor the obturator nerve has any sensory or motor input to the leg distal to the knee. The sciatic nerve runs with the posterior cutaneous nerve of the thigh and provides sensory and motor innervation to the posterior thigh. The sciatic nerve continues posteriorly and divides into the tibial and common peroneal nerves, just cephalad to the popliteal fossa, and provides sensory and motor innervation to the anterior, lateral, and posterior lower leg. Five nerves provide sensory and motor function to the foot. The saphenous nerve supplies sensation to the medial foot and a portion of the great toe. The deep peroneal nerve supplies the web space between the great and second toes. The superficial peroneal nerve supplies most of the dorsum of the foot and toes, while the sural nerve supplies the lateral foot and a portion of the fifth toe. The posterior tibial nerve divides into the medial and lateral plantar nerves and supplies the sole and plantar surface of the toes (Tran et al., Reg Anesth Pain Med, 2019). All of these nerves and plexuses are potentially targeted by a US-guided needle, in order to deliver a planned mixture of anesthetic solution, to achieve an anesthetic or prolonged analgesic effect on the surgically treated body segment (Crutchfield et al., Am J Sports Med 51:279–297, 2023).