Lower Extremity Blocks: Ankle Block

Abstract

Ankle block is a reliable and effective regional technique to provide surgical anesthesia and post-operative analgesia for a variety of foot surgeries. It involves blocking five peripheral nerves at the level of the ankle; four of which are branches of the sciatic nerve (posterior tibial nerve, sural nerve, superficial peroneal and deep peroneal nerve) while one is a terminal branch of the femoral nerve (saphenous nerve). Ankle block is a great alternative to general anesthesia in patients with comorbid conditions where general anesthesia may pose challenges and complications. It can also be a good alternative to a combination femoral /sciatic nerve block as it has the advantage of decreased motor blockade and less impairment to mobilization; with benefits in both inpatient and outpatient surgery. Although, ultrasound can be utilized for an ankle block, the block can easily be done using anatomic landmarks with high success rates. In this summary, we will describe both techniques.