Assessment of lower extremity nerve block: Reprise of the Four P's acronym

Background and Objectives: Successful performance of lower-extremity regional anesthesia includes sensory and/or motor block assessment of up to 4 major peripheral nerves. This brief report describes a methodology for the rapid evaluation of lower-extremity anesthesia before surgical incision. Methods: Illustrations highlight the techniques for evaluation of sciatic, obturator, lateral femoral cutaneous, and femoral nerve anesthesia. This methodology is based on a Four P's acronym: push, pull, pinch, punt. Conclusions: Accurate assessment of lower-extremity regional anesthesia can be achieved rapidly using The Four Ps evaluation tool. Reg Anesth Pain Med 2002;27:618-620.