Sural Nerve Block

Excerpt

The sural nerve block is a regional anesthetic technique used as an alternative or adjunct to general anesthesia for foot and ankle surgery (Figure 1). Peripheral nerve blockade of the sural nerve is notably easy to perform since the nerve courses superficially above and at the ankle., One of the first reports and description of the sural nerve block dates back to 1965 when McCutcheon and colleagues reported a 10% failure rate. Ultrasound-guided sural nerve blockade is a more modern option; however, this small nerve is not typically visualized, and perivascular approaches may lead to improved block success. A traditional ankle block is comprised of peripheral nerve blocks to four other major nerves of the ankle, including the superficial peroneal, deep peroneal, saphenous, and tibial nerve, and may or may not include the sural nerve block depending on surgical exposure. However, the provider should include the sural nerve block regardless of operative location within the foot because deep sensory nerve block of the lateral foot and ankle (e.g., vibration coverage) is often desirable for patient comfort.