158 results match your criteria Nerve Block Posterior Tibial

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

Braz J Anesthesiol 2021 Apr 26. Epub 2021 Apr 26.

Hospital of Qingdao University, Department of Obstetrics, 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

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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

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Localization of nerve entry points as targets to block spasticity of the deep posterior compartment muscles of the leg.

Clin Anat 2017 Oct 22;30(7):855-860. Epub 2017 May 22.

Department of Anatomy, Zunyi Medical College, Zunyi, Guizhou, China.

To identify the optimal body surface puncture locations and the depths of nerve entry points (NEPs) in the deep posterior compartment muscles of the leg, 60 lower limbs of thirty adult cadavers were dissected in prone position. A curved line on the skin surface joining the lateral to the medial epicondyles of the femur was taken as a horizontal reference line (H). Another curved line joining the lateral epicondyle of the femur to the lateral malleolus was designated the longitudinal reference line (L). Read More

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October 2017

Ultrasound-guided therapeutic injections for neural pathology about the foot and ankle: a 4 year retrospective review.

Skeletal Radiol 2017 Jun 16;46(6):795-803. Epub 2017 Mar 16.

Center for Musculoskeletal Care, New York University Langone Medical Center, New York, NY, USA.

Objective: To describe a 4-year clinical experience with ultrasound-guided therapeutic perineural injections of peripheral nerves about the foot and ankle.

Materials And Methods: Retrospective analysis of foot and ankle perineural injections performed between January 2012 and August 2016. Demographics, clinical indications, presence of structural pathology, immediate and interval pain relief, as well as complications were recorded. Read More

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3D ultrasound estimation of the effective volume for popliteal block at the level of division.

Rev Esp Anestesiol Reanim 2017 Mar 20;64(3):125-130. Epub 2016 Oct 20.

Departamento de Anestesiología, Hospital Clinic, Universitat de Barcelona, Barcelona, España.

Local anaesthetic injection between the tibial and commmon peroneal nerves within connective tissue sheath results in a predictable diffusion and allows for a reduction in the volume needed to achieve a consistent sciatic popliteal block. Using 3D ultrasound volumetric acquisition, we quantified the visible volume in contact with the nerve along a 5cm segment.

Methods: We included 20 consecutive patients scheduled for bunion surgery. Read More

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The effect of obesity on the anatomical relationship of the popliteal artery and tibial nerve in the proximal and distal popliteal fossa: relevance to popliteal sciatic nerve block and a traceback technique using the popliteal artery.

J Clin Anesth 2016 Nov 19;34:540-6. Epub 2016 Jul 19.

Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR 97239, USA.

Study Objective: To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa.

Design: Prospective, observational study.

Setting: University medical center. Read More

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November 2016

Plantar pressure displacement after anesthetic motor block and tibial nerve neurotomy in spastic equinovarus foot.

J Rehabil Res Dev 2016 ;53(2):219-28

Institut Régional de Médecine Physique et de Réadaptation Nancy, Centre de Médecine Physique et de Réadaptation, Lay Saint Christophe, France;

The aim of this study was to analyze the displacements of center of pressure (COP) using an in-shoe recording system (F-Scan) before and after motor nerve block and neurotomy of the tibial nerve in spastic equinovarus foot. Thirty-nine patients (age 45 ± 15 yr) underwent a motor nerve block; 16 (age 38 ± 15.2 yr) had tibial neurotomy, combined with tendinous surgery (n = 9). Read More

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January 2018

[Postoperative analgesia effect of different background volumes of ropivacaine in continuous tibial nerve block in patients with calcaneal surgery].

J Yi L Xu H H Lin

Beijing Da Xue Xue Bao Yi Xue Ban 2016 Apr;48(2):283-6

Department of Anesthesia, Beijing Jishuitan Hospital, Beijing 100035, China.

Objective: To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.

Methods: This study was a prospective, randomized, controlled study. Sixty cases of calcaneal visual analogue scale (ASA) I or II undergoing elective surgery were selected and randomly assigned to two groups, thirty cases in each group. Read More

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Treatment of tibia avulsion fracture of posterior cruciate ligament with high-strength suture fixation under arthroscopy.

Eur J Trauma Emerg Surg 2017 Feb 11;43(1):137-143. Epub 2015 Dec 11.

Biomechanics and Medical Information Institute, Beijing University of Technology, 100022, Beijing, People's Republic of China.

Aim: To evaluate the outcome of arthroscopy treatment using high-strength line in the treatment of tibial avulsion fracture of posterior cruciate ligament.

Methods: Both the avulsed bone block and the tibia bone bed were refreshed. The procedure was completed with the assistance of PCL director drill guide. Read More

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February 2017

ED ultrasound-guided posterior tibial nerve blocks for calcaneal fracture analagesia.

Am J Emerg Med 2016 Jun 9;34(6):1183.e1-3. Epub 2015 Nov 9.

Emergency Department, Highland Hospital-Alameda Health System, Oakland, CA; University of California, San Francisco, School of Medicine, San Francisco, CA.

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Middle East J Anaesthesiol 2015 Jun;23(2):171-6

Objective: Block of the sciatic nerve at the popliteal fossa can be performed using the ultrasound machine; it may be proximally or distally to the bifurcation of the sciatic nerve using lateral, medial, or posterior approaches. It is frequently used for surgeries below the knee specially the foot and ankle operations.

Purpose: This study compares one and two injections of the sciatic nerve in the popliteal fossa with ultrasound-guided block in foot or ankle surgeries. Read More

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