Ultrasound: Ankle and Foot Blocks

June 10, 2024/1,195 Comments/in Volume 5; Issue 1: January-June 2024/by Ijraijraadmin

Vol 5 | Issue 1 | January-June 2024 | Page 07-13| Divesh Arora

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.084

Authors: Divesh Arora [1]

[1] Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.

Address of Correspondence

Dr. Divesh Arora,
Director & HOD, Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.
E-mail: drdivesh@gmail.com

Abstract

Ankle blocks are regional anaesthetic techniques used for foot surgery and pain management. Traditionally performed with anatomical landmarks, ultrasound-guided ankle and foot blocks have emerged as a pivotal technique in regional anaesthesia, offering enhanced precision and safety over traditional methods. This review article examines the current practices in ultrasound-guided ankle and foot blocks, including the necessary equipment, sonoanatomy, and injection techniques for various nerves. This comprehensive review aims to equip anaesthesiologists with the knowledge to effectively implement ultrasound-guided ankle and foot blocks, ultimately optimizing pain management and procedural success in lower extremity interventions.
Keywords: Ankle block, Ultrasound guidance, Foot and ankle surgery

References

1. Han JR, Tran J, Agur AM. Overview of the Innervation of Ankle Joint. Physical Medicine and Rehabilitation Clinics. 2021 Nov 1;32(4):791-801.
2. Moosa F, Allan A, Bedforth N. Regional anaesthesia for foot and ankle surgery. BJA education. 2022 Nov 1;22(11):424-31.
3. Sharrow CM, Elmore B. Anesthesia for the Patient Undergoing Foot and Ankle Surgery. Clinics in Sports Medicine. 2022 Apr 1;41(2):263-80.
4. Madhavi C, Isaac B, Antoniswamy B, Holla SJ. Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 2005 Apr;18(3):206-9.
5. Mercer D, Morrell NT, Fitzpatrick J, Silva S, Child Z, Miller R, DeCoster TA. The course of the distal saphenous nerve: a cadaveric investigation and clinical implications. The Iowa orthopaedic journal. 2011;31:231.
6. López AM, Sala-Blanch X, Magaldi M, Poggio D, Asuncion J, Franco CD. Ultrasound-guided ankle block for forefoot surgery: the contribution of the saphenous nerve. Regional Anesthesia & Pain Medicine. 2012 Sep 1;37(5):554-7.
7. Gbejuade H, Squire J, Dixit A, Kaushik V, Mangwani J. Ultrasound-guided regional anaesthesia in foot and ankle surgery. Journal of Clinical Orthopaedics and Trauma. 2020 May 1;11(3):417-21.
8. Korwin-Kochanowska K, Potié A, El-Boghdadly K, Rawal N, Joshi G, Albrecht E. PROSPECT guideline for hallux valgus repair surgery: a systematic review and procedure‐specific postoperative pain management recommendations. Regional Anesthesia & Pain Medicine. 2020 Sep 1;45(9):702-8.
9. Lee M, Lee C, Lim J, Kim H, Choi YS, Kang H. Comparison of a Peripheral Nerve Block versus Spinal Anesthesia in Foot or Ankle Surgery: A Systematic Review and Meta-Analysis with a Trial Sequential Analysis. Journal of Personalized Medicine. 2023 Jul 4;13(7):1096.
10. Schipper ON, Hunt KJ, Anderson RB, Davis WH, Jones CP, Cohen BE. Ankle block vs single-shot popliteal fossa block as primary anesthesia for forefoot operative procedures: prospective, randomized comparison. Foot & ankle international. 2017 Nov;38(11):1188-91.
11. Roberts VI, Aujla RS, Fombon FN, Singh H, Bhatia M. Is regional ankle block needed in conjunction with general anaesthesia for first ray surgery? A randomised controlled trial of ultrasound guided ankle block versus “blind” local infiltration. Foot and Ankle Surgery. 2020 Jan 1;26(1):66-70.
12. Chin KJ, Wong NW, Macfarlane AJ, Chan VW. Ultrasound-guided versus anatomic landmark-guided ankle blocks: a 6-year retrospective review. Regional Anesthesia & Pain Medicine. 2011 Oct 1;36(6):611-8.
13. Redborg KE, Antonakakis JG, Beach ML, Chinn CD, Sites BD. Ultrasound improves the success rate of a tibial nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2009 Apr 1;34(3):256-60.
14. Redborg KE, Sites BD, Chinn CD, Gallagher JD, Ball PA, Antonakakis JG, Beach ML. Ultrasound improves the success rate of a sural nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2009 Jan 1;34(1):24-8.
15. Antonakakis JG, Scalzo DC, Jorgenson AS, Figg KK, Ting P, Zuo Z, Sites BD. Ultrasound does not improve the success rate of a deep peroneal nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2010 Feb 1;35(2):217-21.
16. Lee JK, Lee GS, Kim SB, Kang C, Kim KS, Song JH. A Comparative Analysis of Pain Control Methods after Ankle Fracture Surgery with a Peripheral Nerve Block: A Single-Center Randomized Controlled Prospective Study. Medicina. 2023 Jul 14;59(7):1302.
17. Marty P, Rontes O, Chassery C, Vuillaume C, Basset B, Merouani M, Marquis C, Bataille B, Chaubard M, Mailles MC, Ferré F. Perineural versus systemic dexamethasone in front-foot surgery under ankle block: a randomized double-blind study. Regional Anesthesia & Pain Medicine. 2018 Oct 1;43(7):732-7.
18. Dawson RL, McLeod DH, Koerber JP, Plummer JL, Dracopoulos GC. A randomised controlled trial of perineural vs intravenous dexamethasone for foot surgery. Anaesthesia. 2016 Mar;71(3):285-90.
19. Kahn RL, Ellis SJ, Cheng J, Curren J, Fields KG, Roberts MM, YaDeau JT. The incidence of complications is low following foot and ankle surgery for which peripheral nerve blocks are used for postoperative pain management. HSS Journal®. 2018 Jul;14(2):134-42.
20. Lauf JA, Huggins P, Long J, Mohammed AI, Byrne B, Large BP, Whitehead B, Cheney NA, Law Sr TD. Regional nerve block complication analysis following peripheral nerve block during foot and ankle surgical procedures. Cureus. 2020 Jul 28;12(7).

How to Cite this Article: Arora D | Ultrasound: Ankle and Foot Blocks | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 07-13 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.84