Pharm

Leg Regional Anesthesia

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Leg Regional Anesthesia, Ultrasound Guided Regional Anesthesia of the Lower Extremity, Nerve Block of the Foot and Ankle, Foot and Ankle Regional Anesthesia, Ultrasound-Guided Ankle Block

  • Indications
  1. Regional Anesthesia to allow for procedures (in place of Procedural Sedation)
  2. Severe localized pain control (e.g. Ankle Fracture)
    1. Consider Hematoma Block
  • Contraindications
  1. Perform 1-2 Nerve Blocks under Ultrasound guidance
    1. Posterior Tibial Nerve Block
    2. Deep Peroneal Nerve Block (optional)
      1. Deep peroneal nerve only innervates first web space
      2. If Anesthesia is not needed in this region, may avoid Deep Peroneal Nerve Block
  2. Perform Field Block (non-Ultrasound guided) of the anterior ankle
    1. Saphenous Nerve (Medial ankle)
      1. Inject 5 ml SQ in transverse plane, from medial malleolus toward anterior ankle
    2. Sural Nerve (Lateral ankle)
      1. Inject 5 ml SQ in transverse plane, from anterior ankle toward lateral malleolus
  3. References
    1. Ankle Block (Nysora, accessed 12/22/2020)
      1. https://www.nysora.com/regional-anesthesia-for-specific-surgical-procedures/lower-extremity-regional-anesthesia-for-specific-surgical-procedures/foot-and-anckle/ankle-block/
  • Complications
  1. See Regional Anesthesia
  2. Nerve injury with persistent Paresthesias
  3. See Local Anesthetic System Toxicity (LAST)