167 results match your criteria Nerve Block Posterior Tibial

"High ankle block" for surgery at the ankle joint.

Foot Ankle Surg 2022 May 26. Epub 2022 May 26.

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Germany.

Background: Surgery around the ankle is increasingly embedded in outpatient treatment concepts. Unfortunately, the classic "ankle block" as a concept of regional anesthesia is inappropriate for surgery around the ankle because the injection sites are too distal to block this specific region.

Methods: The "high ankle block" avoids this disadvantage by dislocating the injection points 15 cm proximal to the malleoli. Read More

View Article and Full-Text PDF

Avoidance of injury to the posterior neurovascular bundle during total ankle arthroplasty - A simple technical tip.

Foot Ankle Surg 2022 Apr 29. Epub 2022 Apr 29.

Sheffield Teaching Hospitals NHS Foundation Trust, UK.

Iatrogenic nerve injury to the tibial nerve is a serious but avoidable complication of total ankle replacements and may be under-reported as it may go unrecognised or thought to be due to tarsal tunnel syndrome. The tibial nerve is particularly vulnerable during the saw cuts at the posteromedial corner without appropriate protection. Prior to drilling the tibial and talar pins of the adjustment block for the Infinity ankle replacement we perform a 2 cm incision behind the medial malleolus. Read More

View Article and Full-Text PDF

Regional haemodynamic variables and perfusion index in the evaluation of sciatic nerve block: a prospective observational trial.

BMJ Open 2022 05 2;12(5):e057283. Epub 2022 May 2.

Department of Anesthesiology, Ningbo Huamei Hospital University of Chinese Academy of Sciences, Ningbo, China

Objective: We determined whether regional haemodynamics and perfusion index (PI) could be reliable indicators of a successful sciatic nerve block (SNB).

Design: Prospective observational trial.

Setting: A tertiary teaching hospital in China from April 2020 to August 2020. Read More

View Article and Full-Text PDF

Pain Management Optimisation by an Ultrasound-Guided Analgesic Technique in Outpatients with Plantar Fasciitis during High-Energy Extracorporeal Shock Wave Therapy.

Turk J Anaesthesiol Reanim 2021 Oct;49(5):350-356

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Patna, India;Istituto di Anestesiologia e Rianimazione, Universita Cattolica Del Sacro Cuore, Rome, Italy.

Objective: Several studies have demonstrated the efficacy of high-energy extracorporeal shock wave therapy (HESWT) for the treatment of painful foot diseases. A crucial complication of HESWT is the appearance of pain with the subsequent interruption of the procedure. The aim of this study was the evaluation of ultrasound (US)-guided posterior tibial nerve block (PTNB) efficacy in outpatients who discontinued the first application of HESWT due to surge of moderate-severe pain. Read More

View Article and Full-Text PDF
October 2021

The effect of posterior tibial and sural nerve blocks on postoperative pain of patients following open reduction and internal fixation of calcaneal fractures.

Foot Ankle Surg 2021 Nov 24. Epub 2021 Nov 24.

Orthopedic Foot and Ankle Surgeon, Department of Orthopedic Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Introduction: Postoperative pain control and achieving opioid-free anesthesia are major issues for surgically treated patients with calcaneal fractures. We evaluated the potential role of posterior tibial and sural nerve blocks as a part of multimodal pain control techniques in patients underwent open reduction and internal fixation (ORIF) of calcaneal fractures via extensile lateral approach.

Methods: Forty-eight patients randomly allocated to receive either posterior tibial and sural nerve blocks with bupivacaine (peripheral nerve block (PNB) group) or normal saline, after induction of general anesthesia. Read More

View Article and Full-Text PDF
November 2021

Ultrasound-guided diagnostic IPACK as a valuable tool in the management of a patient with soleal sling syndrome: a doubly rare case report.

Pain Manag 2022 Jan 21;12(1):5-12. Epub 2021 Jul 21.

Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA.

This article describes the use of an infiltration between the popliteal artery and capsule of the knee joint (IPACK) to diagnose an entrapment neuropathy of the tibial nerve (TN) in a patient presenting with chronic neuropathic pain in the medial posterior compartment of the left knee, with a previous electromyography showing no evidence of tibial or common peroneal nerve neuropathy. After a positive sciatic nerve block, the patient was evaluated for a TN block, cancelled due to the presence of an abnormal leash of vessels wrapping around the nerve. For this reason, the patient was submitted to a diagnostic IPACK. Read More

View Article and Full-Text PDF
January 2022

Bifurcation of the sciatic nerve: A descriptive study on a South African cadaver cohort.

Morphologie 2021 May 26. Epub 2021 May 26.

Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa. Electronic address:

Background: The sciatic nerve bifurcates into the tibial and common fibular nerves in six different regions: the pelvic region, gluteal region, proximal, middle, or distal third of the posterior thigh, or in the popliteal fossa. Inadequate knowledge of sciatic nerve anatomy could lead to failed nerve blocks, and damage during intramuscular injections. Limited studies have been done on African population groups and lack a quantifiable method to classify the levels of sciatic nerve bifurcation. Read More

View Article and Full-Text PDF

Infiltration between the popliteal artery and the capsule of the knee (IPACK) block in knee surgery: a narrative review.

Reg Anesth Pain Med 2021 09 14;46(9):784-805. Epub 2021 May 14.

Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK

Background: The infiltration between the popliteal artery and the capsule of the knee (IPACK) block has been described as an alternative analgesic strategy for knee pain.

Objective: Our aim was to perform a narrative review to examine the place and value that the IPACK block has in comparison to and in conjunction with other regional anesthesia modalities.

Evidence Review: Following an extensive search of electronic databases, we included anatomical studies, letters, comparative observational studies, and non-randomized and randomized controlled trials that examined the IPACK block in relation to surgery on the knee under general or neuraxial anesthesia. Read More

View Article and Full-Text PDF
September 2021

Location of motor branches of tibialis posterior muscle and its relation in treatment of spastic equinovarus foot: a cadaveric study.

Braz J Anesthesiol 2022 Mar-Apr;72(2):286-290. Epub 2021 Apr 26.

Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, China. Electronic address:

Background And Objectives: Nerve block or neurolysis is an important approach in the treatment of spastic equinovarus foot. To illustrate the accurate location of the nerve branch to the tibialis posterior muscle (TP) in clinical practice, 21 adult cadavers were dissected and 14 complete both lower limb specimens were obtained. A total of 28 lower limbs were included. Read More

View Article and Full-Text PDF

Variable Branching Pattern of Tibial Nerve in the Tarsal Tunnel: A Gross Anatomical Study With Clinical Implications.

Cureus 2021 Mar 6;13(3):e13729. Epub 2021 Mar 6.

Anatomy, Regional Institute of Medical Sciences, Imphal, IND.

Introduction Tibial nerve is a larger component of the sciatic nerve. It arises from ventral branches (Anterior Division) - L4, L5, S1-S3. Then it travels along the distal border of the popliteus muscle, deep to gastrocnemius and soleus. Read More

View Article and Full-Text PDF

National Trends in Neuromodulation for Urinary Incontinence Among Insured Adult Women and Men, 2004-2013: The Urologic Diseases in America Project.

Urology 2021 04 6;150:86-91. Epub 2020 Dec 6.

Section of Urology, Virginia Mason Medical Center, Seattle, WA.

Objective: To examine US trends in neuromodulation for urinary incontinence (UI) treatment from 2004 to 2013.

Methods: This study utilized 2 data sources: the Optum© de-identified Clinformatics® Data Mart Database for privately insured adults aged 18-64 years with a UI diagnosis (N≈40,000 women and men annually) and the Medicare 5% Sample for beneficiaries aged ≥65 years with a UI diagnosis (N≈65,000 women and men annually). We created annual cross-sectional cohorts and assessed prevalence of UI-related neuromodulation procedures among men and women separately from 2004 to 2013. Read More

View Article and Full-Text PDF

Ultrasound Guided Posterior Tibial Nerve Block to Facilitate Foreign Body Removal in a School-Aged Child.

Glob Pediatr Health 2020 24;7:2333794X20947982. Epub 2020 Aug 24.

Hasbro Children's Hospital, Providence, RI, USA.

View Article and Full-Text PDF

Landmark Technique vs Ultrasound-Guided Approach for Posterior Tibial Nerve Block in Cadaver Models.

Indian J Orthop 2020 Feb 13;54(1):38-42. Epub 2020 Jan 13.

3Department of Orthopaedic Surgery, University of Kentucky Albert B. Chandler Hospital, Lexington, USA.

Background: The use of ultrasound for peripheral nerve blocks has proven extremely useful for improving the accuracy and efficacy of many regional anesthetic techniques. There remain a few nerve blocks which have lagged behind in employing the assistance of ultrasound consistently, one of which is the ankle block. This block is commonly utilized for either surgical anesthesia or post-operative analgesia for a variety of foot and ankle procedures. Read More

View Article and Full-Text PDF
February 2020

Motor-sparing effect of iPACK (interspace between the popliteal artery and capsule of the posterior knee) block versus tibial nerve block after total knee arthroplasty: a randomized controlled trial.

Reg Anesth Pain Med 2020 04 4;45(4):267-276. Epub 2020 Feb 4.

Orthopaedics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Background And Objective: An ultrasound-guided anesthetic technique targeting the interspace between the popliteal artery and capsule of the posterior knee (iPACK) can provide posterior knee analgesia with preserved motor function after total knee arthroplasty (TKA). This study compared the peroneal nerve motor-sparing effects of iPACK block and tibial nerve block (TNB) when combined with local infiltration analgesia (LIA) and continuous adductor canal block (CACB).

Methods: In this study, 105 patients scheduled for elective TKA were randomized to receive proximal iPACK block (iPACK1), distal iPACK block (iPACK2), or TNB, along with spinal anesthesia, modified LIA, and CACB. Read More

View Article and Full-Text PDF

Distal Bypass Grafting Using the Basilic-Cephalic Loop Vein for Chronic Limb-Threatening Ischemia under Peripheral Nerve Blockades in a Patient with Severely-Reduced Heart Function and End-Stage Renal Disease.

Ann Vasc Dis 2019 Dec;12(4):551-554

Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

A 51-year-old man with severe comorbidities required redo revascularization due to left chronic limb-threatening ischemia caused by a previous vein graft occlusion. The saphenous veins were not available due to previous surgeries. Femoro-posterior tibial artery bypass surgery was successfully performed using the basilic-cephalic loop vein under peripheral nerve blockades. Read More

View Article and Full-Text PDF
December 2019

Investigation of genicular neurotomy of the knee: MRI characterization of anatomy and implications for intervention.

Clin Imaging 2020 Jan 9;59(1):78-83. Epub 2019 Nov 9.

Department of Physical Medicine and Rehabilitation, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065, United States of America.

Background: Genicular nerve block and subsequent radiofrequency neurotomy (RFN) has emerged as a novel intervention and alternative for total knee arthroplasty in patients with refractory pain from knee osteoarthritis (OA). To our knowledge, there is no cited report correlating the accuracy of localizing the genicular nerves using bony landmarks on magnetic resonance imaging (MRI).

Objectives: To quantify the proximity of superomedial genicular nerve (SMGN), superolateral genicular nerve (SLGN), and inferomedial genicular nerve (IMGN) from a target point. Read More

View Article and Full-Text PDF
January 2020

Coccydynia relieved by a tarsal tunnel block: a case series.

Amjid Hammodi

J Med Case Rep 2019 Nov 21;13(1):339. Epub 2019 Nov 21.

, Baghdad, Iraq.

Background: This case series describes, for the first time, to the author's knowledge, a novel treatment for coccydynia. Tarsal tunnel block with lignocaine only brought relief of chronic coccydynia lasting more than 6 months in three patients. The author adopts the theory that the myelin sheath of the posterior tibial nerve will convey the lipid-soluble lignocaine upward toward the dorsal root ganglia and the nerve roots of the lumbar spine through the uninterrupted myelin sheath, which is itself mainly formed of lipids. Read More

View Article and Full-Text PDF
November 2019

Morphology of saphenous nerve in cadavers: a guide to saphenous block and surgical interventions.

Anat Cell Biol 2019 Sep 26;52(3):262-268. Epub 2019 Sep 26.

Department of Anatomy, Medical University of the Americas, Charlestown, Saint Kitts and Nevis, West Indies.

The knowledge about detailed morphology and relation of saphenous nerve is important to obtain successful saphenous nerve regional blocks to achieve pre- and post-operative anesthesia and analgesia, nerve entrapment treatments and to avoid damage of saphenous nerve during knee and ankle surgeries. The literature describing detailed morphology of saphenous nerve is very limited. We dissected 42 formalin fixed well embalmed cadaveric lower limbs to explore detailed anatomy, relation and mode of termination of saphenous nerve and measured the distances from the nearby palpable bony landmarks. Read More

View Article and Full-Text PDF
September 2019

Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study.

Surg Radiol Anat 2019 Dec 23;41(12):1461-1471. Epub 2019 Jul 23.

Neuro-Musculo-Skeletal Pole (NMSK), Experimental and Clinical Research Institute (IREC), Université Catholique de Louvain (UCLouvain), Tour Pasteur, Avenue Mounier 53, 1200, Brussels, Belgium.

Background: Despite their emerging therapeutic relevance, there are many discrepancies in anatomical description and terminology of the articular nerves supplying the human knee capsule. This cadaveric study aimed to determine their origin, trajectory, relationship and landmarks for therapeutic purpose.

Methods: We dissected 21 lower limbs from 21 cadavers, to investigate the anatomical distribution of all the articular nerves supplying the knee joint capsule. Read More

View Article and Full-Text PDF
December 2019

Ultrasound-Guided Posterior Tibial Nerve Block for Plantar Foot Foreign Body Removal.

Pediatr Emerg Care 2020 May;36(5):262-265

Emergency Medicine, Medical University of South Carolina, Charleston, SC.

Ultrasound-guided regional anesthesia is a growing modality within the pediatric emergency department. Here we present a case where a posterior tibial nerve block was used for anesthesia during foreign body removal from the plantar foot. We further review the technique and literature regarding this straightforward and highly effective procedure. Read More

View Article and Full-Text PDF

Optimal location of local anesthetic injection in the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study.

Korean J Anesthesiol 2019 10 30;72(5):486-494. Epub 2019 Apr 30.

Department of Orthopedics, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Background: This study aimed to determine the optimal location of local anesthetic injection in the interspace between the popliteal artery and posterior capsule of the knee (iPACK), using the anatomical pattern of the articular branch of tibial nerve (ABTN). We hypothesized that injection at the level of ABTN forming a popliteal plexus would mainly spread throughout the popliteal fossa without contacting the tibial or peroneal nerves.

Methods: The anatomical study included 30 soft cadavers. Read More

View Article and Full-Text PDF
October 2019

Anatomical study of the innervation of posterior knee joint capsule: implication for image-guided intervention.

Reg Anesth Pain Med 2019 Feb;44(2):234-238

Division of Anatomy, Department of Surgery, University of Toronto, Toronto, Canada.

Background And Objectives: Peripheral nerve block is an important component of the multimodal analgesia for total knee arthroplasty. Novel interventional techniques of ultrasound-guided nerve block supplying the posterior knee joint capsule require knowledge of the innervation of the posterior capsule. The objectives of this cadaveric study were to determine the course, frequency, and distribution of the articular branches innervating the posterior knee joint capsule and their relationships to anatomical landmarks. Read More

View Article and Full-Text PDF
February 2019

Opioid-Sparing Analgesia and Enhanced Recovery After Total Knee Arthroplasty Using Combined Triple Nerve Blocks With Local Infiltration Analgesia.

J Arthroplasty 2019 02 13;34(2):295-302. Epub 2018 Oct 13.

Department of Orthopaedics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.

Background: Peripheral nerve block and local infiltration analgesia (LIA) have an increasing role as part of multimodal analgesia for enhanced recovery after total knee arthroplasty (TKA). We hypothesized that the combination of obturator nerve block (ONB) and tibial nerve block (TNB) would reduce pain and opioid consumption more than ONB or TNB alone when combined with continuous adductor canal block and LIA.

Methods: Ninety patients were recruited into the study and received spinal anesthesia, LIA, and continuous adductor canal block. Read More

View Article and Full-Text PDF
February 2019

Interspace between Popliteal Artery and posterior Capsule of the Knee (IPACK) Injectate Spread: A Cadaver Study.

J Ultrasound Med 2019 Mar 19;38(3):741-745. Epub 2018 Sep 19.

Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Objectives: Local anesthetic injection into the interspace between the popliteal artery and the posterior capsule of the knee (IPACK) has the potential to provide motor-sparing analgesia to the posterior knee after total knee arthroplasty. The primary objective of this cadaveric study was to evaluate injectate spread to relevant anatomic structures with IPACK injection.

Methods: After receipt of Institutional Review Board Biospecimen Subcommittee approval, IPACK injection was performed on fresh-frozen cadavers. Read More

View Article and Full-Text PDF

The short-term effects of posterior tibial nerve stimulation on anorectal physiology in patients with faecal incontinence: a single centre experience.

Therap Adv Gastroenterol 2018 1;11:1756284818786111. Epub 2018 Jul 1.

University Hospital of South Manchester, Manchester, UK.

Background: Posterior tibial nerve stimulation (PTNS) is a novel treatment for patients with faecal incontinence (FI) and may be effective in selected patients; however, its mechanism of action is unknown. We sought to determine the effects of PTNS on anorectal physiological parameters.

Methods: Fifty patients with FI underwent 30 min of PTNS treatment, weekly for 12 weeks. Read More

View Article and Full-Text PDF

The analgesic effect of a popliteal plexus blockade after total knee arthroplasty: A feasibility study.

Acta Anaesthesiol Scand 2018 May 24. Epub 2018 May 24.

Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark.

Introduction: An obturator nerve block (ONB) and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA) without impeding the ambulation, although the ONB produces motor blockade of the hip adductor muscles. The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating intraarticular genicular structures and the posterior capsule of the knee. We hypothesised that a popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa. Read More

View Article and Full-Text PDF

The Spread of Ultrasound-Guided Injectate From the Adductor Canal to the Genicular Branch of the Posterior Obturator Nerve and the Popliteal Plexus: A Cadaveric Study.

Reg Anesth Pain Med 2017 Nov/Dec;42(6):725-730

From the *Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark; †Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria; and ‡Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital, University of Copenhagen, Copenhagen; and §Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.

Background And Objectives: The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Read More

View Article and Full-Text PDF
September 2018

The Effect of Preemptive Ankle Block using Ropivacaine and Dexamethasone on Postoperative Analgesia in Foot Surgery.

Anesth Essays Res 2017 Apr-Jun;11(2):372-375

Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt.

Background: Peripheral nerve blocks have become an increasingly popular form of anesthesia. Preemptive analgesia reduces central sensitization, postoperative pain, and analgesic consumption. Different additive has been used to prolong regional blockade and improve postoperative analgesia. Read More

View Article and Full-Text PDF

Reduced foot pain after spasticity control with alcohol block in a patient with chronic hemiparetic stroke: a case report.

Min Cheol Chang

J Phys Ther Sci 2017 Apr 20;29(4):767-770. Epub 2017 Apr 20.

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea.

[Purpose] This study report a case of a patient with hemiparetic stroke who showed significantly reduced foot pain when ankle spasticity was reduced using nerve and motor point blocks with 20% ethyl alcohol. [Subject and Methods] A 58-year-old woman with left hemiparesis following intracranial hemorrhage five years previously presented with pain in the left fifth metatarsal head for two years (numeric rating scale[NRS]: 8). Erythema and edema were observed on the lateral aspect of the head of the fifth metatarsal bone. Read More

View Article and Full-Text PDF