II. Indications

  1. Anesthesia of the dorsum of the foot

III. Precautions

  1. Avoid injecting directly into nerves

IV. Preparation

  1. Needle: 27 gauge 1.5 inch
  2. Anesthetic: Lidocaine 1%: two 10 ml syringes

V. Technique

  1. Patient position
    1. Supine position
    2. Ankle slightly plantar flexed
  2. Injection site 1: Superficial peroneal nerve (most of dorsal foot)
    1. Identify site
      1. Anterior tibial border and
      2. Superior to lateral malleolus
    2. Inject 5 cc Lidocaine 1% subcutaneously
  3. Injection site 2: Deep peroneal nerve (first web space only)
    1. Identify site dorsiflexing ankle against resistance
      1. Between tibialis anterior and extensor hallucis l
      2. Approximately at level between malleoli
    2. Insert needle lateral to anterior tibial artery
      1. Aspirate and inject 5 cc Lidocaine 1%
  4. Injection site 3: Saphenous Nerve (lateral ankle only)
    1. Identify site
      1. Superior and anterior to medial malleolus
    2. Inject 3 cc subcutaneously
  5. Warning: Distal Paresthesias with needle with injection
    1. Indicates needle is in nerve
    2. Do not inject here!
    3. Remove needle and reposition

VI. References

  1. Pfenninger (1994) Procedures, Mosby, p. 1036-54
  2. Salam (2004) Am Fam Physician 69(4):896 [PubMed]

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: Local anesthetic deep peroneal nerve block (C0394746)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 231176000
English LA deep peroneal nerve block, Local anesthetic deep peroneal nerve block, Deep peroneal nerve block, Local anaesthetic deep peroneal nerve block, Local anesthetic deep peroneal nerve block (procedure)
Spanish bloqueo con anestesia local de nervio tibial anterior, bloqueo de nervio peroneo profundo con anestésico local (procedimiento), bloqueo con anestesia local de nervio tibial anterior (procedimiento), bloqueo de nervio peroneo profundo con anestésico local

Ontology: Local anesthetic superficial peroneal nerve block (C0394747)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 231177009
English Superfic peroneal nerve block, LA superfic peroneal nrv block, superficial peroneal nerve block, nerve block of superficial peroneal nerve (treatment), nerve block of superficial peroneal nerve, Superficial peroneal nerve block, Local anaesthetic superficial peroneal nerve block, Local anesthetic superficial peroneal nerve block, Local anesthetic superficial peroneal nerve block (procedure)
Spanish bloqueo con anestesia local de nervio musculocutáneo (procedimiento), bloqueo de nervio peroneo superficial con anestésico local, bloqueo con anestesia local de nervio musculocutáneo, bloqueo de nervio peroneo superficial con anestésico local (procedimiento)

Ontology: nerve block of saphenous nerve (C2053692)

Concepts Therapeutic or Preventive Procedure (T061)
English saphenous nerve block, nerve block of saphenous nerve (treatment), nerve block of saphenous nerve