9. Ankle Block Flashcards
ankle block indication
surgery on foot
tourniquet not required
does the ankle block provide analgesia for turniquet pain above the ankle?
no
ankle block common surgeries
bunionectomy
toe amputation
debriedement
podiatric surgery
metatarsal osteotomy
how many nerves must be anesthetized to block the foot
5
which nerves must be blocked to anesthetize the foot
deep peroneal
superficial peroneal
saphenous
posterior tibial
sural
deep peroneal
superficial peroneal
saphenous
posterior tibial
sural
how many deep injections for ankle blocks
2
ankle block deep injections
deep peroneal
posterior tibial
deep injections block
both sensory and motor nerves
how many superficial injections for ankle blocks
3
ankle block superficial injections
superficial peroneal
saphenous
sural
superficial injections block
sensory only
sciatic nerve branches blocked in ankle block
deep peroneal
superficial peroneal
tibial
sural
femoral nerve branches blocked in ankle block
saphenous
deep peroneal nerve block landmark
anterior tibial artery
deep peroneal block needle insertion
lateral to anterior tibial artery
advanced until bone
deep peroneal volume
5mL
deep peroneal anesthetizes
dorsal web space between 1st 2 toes
superficial peroneal block landmark
anterior tibial artery
superficial peroneal needle insertion
lateral to the anterior tibial artery
superficial peroneal needl advancement
advance superficially toward superior lateral malleolus
superficial peroneal volume
3-5 mL
superficial peroneal anesthetizes
dorsum of foot and toes
NOT between 1st 2 toes
saphenous landmark
anterior tibial artery
medial malleolus
saphenous nerve runs
over the anterior portion of the medial malleolus
saphenous needle insertion
lateral to anterior tibial pulse
saphenous needle advancement
superficially towards superior medial malleolus
saphenous volume
3-5 mL
saphenous anesthetizes
medial ankle
medial foot
medial sole
posterior tibial nerve location
posterior to the medial malleolus
posterior tibial landmarks
medial malleolus
posterior tibial artery
posterior tibial needle insertion
posterior and deep to posterior tibial pulse
dorsal to medial malleous
posterior tibial needle advancement
advance until hit tibia
posterior tibial block volume
5 mL
posterior tibial anesthetizes
most of heel
most of the sole
tips of the toes
sural block landmark
achilles tendon
lateral malleolus
sural nerve location
between achilles tendon and lateral malleolus
sural nerve needle insertion
inserted lateral to achilles tendon
sural nerve needle advancement
advanced toward lateral malleolus
sural nerve volume
3-5 mL
sural nerve anesthetizes
lateral foot
lateral heel
lateral/posterior sole
ankle block total volume
15-20 mL per foot
ankle block does not anesthetize
ankle
ankle block advantages
low risk for LAST
fast block
no motor block
ankle block disadvantages
multiple injections
epi can compromise circulation
ankle block CI
foot circulation compromised
foot infection
epi
foot edema