Techniques and complications of popliteal nerve blocks

Foot Ankle Surg. 2022 Oct;28(7):852-857. doi: 10.1016/j.fas.2021.11.008. Epub 2021 Nov 19.

Abstract

Background: Use of popliteal nerve blocks (PNBs) as an alternative or adjunctive therapy to traditional methods of pain control (e.g., systemic or spinal anesthesia and opioids) is increasingly popular in foot and ankle surgery.

Methods: We reviewed online databases for literature on PNBs in foot and ankle surgery to analyze the various techniques and positioning used, the influence of drugs on their efficacy, and possible complications associated with their use. Thirty articles were identified with a predefined search criteria, followed by a review process for relevance.

Results: Patient demographics, procedure specifics, and block techniques, such as anesthetic used, can impact the duration and success of a PNB. Administration with ultrasound guidance proved superior to nerve stimulation, and preoperative administration was superior to postoperative administration.

Conclusions: PNBs are an effective method to control postoperative pain with minimal complications, leading to decreased analgesic use, earlier discharge, and higher patient satisfaction.

Level of evidence: Level III, retrospective comparative study.

Keywords: Anesthetics; Lower extremity; Nerve block; Pain management; Post-Surgical pain.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Humans
  • Nerve Block* / adverse effects
  • Nerve Block* / methods
  • Orthopedic Procedures* / methods
  • Pain Measurement / methods
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Retrospective Studies

Substances

  • Analgesics, Opioid