Thermographic assessment of sciatic nerve block success: a case series
Igor de Freitas Azevedo Atayde, João Paulo Jordão Pontes, Raphael de Almeida Carvalho, Celso Eduardo Rezende Borges, Anastácio de Jesus Pereira, Rodrigo Rodrigues Alves
Abstract
Sciatic nerve block (SNB) success typically relies on subjective patient feedback, lacking an objective gold standard. Infrared thermography (IT) offers a promising objective alternative by detecting skin temperature increases resulting from sympathetic blockade. This case series involved five adults undergoing lower limb surgery receiving ultrasound-guided popliteal SNB. Using a FLIR C5 camera, plantar skin thermal images were captured at 5-minute intervals for 30 minutes, analyzing four specific angiosome-based regions of interest. Successful blocks correlated with significant temperature rises (up to 9°C), confirming sensory and motor blockade. Conversely, partial failures exhibited localized thermal deficits. Combinations of lidocaine and levobupivacaine produced faster thermal responses than levobupivacaine alone. Notably, the thermographic response persisted even in the presence of residual spinal anesthesia. IT provides a noninvasive, objective tool for real-time monitoring of SNB success. It is especially beneficial when patient feedback is unavailable, though further prospective studies are required to define standardized diagnostic thresholds.
Keywords
References
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Submitted date:
12/02/2025
Accepted date:
06/19/2026
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