Lower Extremity Blocks
Pp. 57-79 (23)
Roy Greengrass and Arun Kalava
Lower extremity blocks provide anesthesia and analgesia for a variety of
orthopedic, vascular and cosmetic procedures involving the hip, the thigh, the knee, the
leg, the ankle and the foot. Lower extremity blocks include the femoral nerve block,
(FNB), the sciatic nerve block, the popliteal sciatic nerve block, the saphenous nerve
block, the posterior lumbar plexus block and the ankle block. A combination of lumbar
plexus and sciatic block provides complete anesthesia of the lower extremity. The
femoral nerve block is among the easiest, safest, and the most successful blocks to
master. This block can provide analgesia for a fractured hip, a femoral fracture, knee
arthroplasty and the harvesting of skin from the thigh. The popliteal block when
combined with the saphenous block provides complete anesthesia below the knee.
When the ankle block is performed above the malleoli, complete anesthesia of the foot
can be achieved. The use of regional-lower extremity blocks helps to avoid the risks of
general or neuroaxial anesthesia especially for those who are frail, debilitated, with
multiple co-morbidities and cardiovascular risk factors. In addition, lower extremities
blocks can provide significant post-operative analgesia. The blocks maybe performed
with the use of the ultrasound or with peripheral nerve stimulation.
Adductor canal block, Ankle block, Femoral nerve blocks, Lower
extremity blocks, Lumbar plexus block, Popliteal block, Saphenous nerve block,
Sciatic nerve block.
Mayo Clinic, Jacksonville, Florida, USA.