Ayak Bileği Bloğu

Ankle block is an effective regional anesthesia method applied in foot and toe surgeries that do not require tourniquet use. Sensory innervation of the region is provided by the superficial peroneal, deep peroneal, tibial, and sural nerves—which are branches of the sciatic nerve—and the saphenous nerve, which is the terminal branch of the femoral nerve originating from the lumbar plexus. For the block procedure, the patient is placed in a supine position, and the foot is elevated with the support of a pillow and rotated appropriately according to the targeted nerve. The ankle block primarily consists of a combination of deep peroneal, superficial peroneal, tibial, sural, and saphenous nerve blocks. This procedure can be performed using traditional anatomical landmarks via subcutaneous or deep local anesthetic injection, as well as under ultrasound (USG) guidance using in-plane or out-of-plane approaches to clearly visualize nerve and vascular structures. Following the application, complications such as infection, hematoma, local anesthetic systemic toxicity, and rare nerve injury may occur. Underlying pathologies such as diabetic neuropathy, prolonged block duration, tourniquet use, and patient positioning are important factors influencing the risk of nerve damage. To ensure successful anesthesia and minimize potential risks, anatomy should be carefully evaluated prior to injection, low volumes should be preferred while avoiding high volumes, injection must be stopped immediately if resistance is felt to reposition the needle, and small-gauge needles such as 25G should be used.