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Journal of the American Podiatric Medical Association
Volume 94 Number 4 368-374 2004
Copyright © 2004 American Podiatric Medical Association

Combined Popliteal and Saphenous Nerve Blocks at the Knee

An Underused Alternative to General or Spinal Anesthesia for Foot and Ankle Surgery

Cornelius M. Donohue, DPM *, Larry R. Goss, DPM {dagger}, Samuel Metz, MD {ddagger}, Michael S. Weingarten, MD, MBA § and Larry B. Dyal, Jr, DPM, MS ||

* Department of Podiatric Surgery, Hahnemann University Hospital, Philadelphia, PA.
{dagger} Surgical Residency Program, Tenet Parkview Hospital and Medical College of Pennsylvania Hospital, Philadelphia; Temple University School of Podiatric Medicine, Philadelphia, PA; private practice, Philadelphia Foot & Ankle, Philadelphia, PA.
{ddagger} Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, PA.
§ Wound Healing Program, Medical College of Pennsylvania Hospital, Philadelphia.
|| Tenet Parkview Hospital and Medical College of Pennsylvania Hospital, Philadelphia.

Corresponding author: Cornelius M. Donohue, DPM, 748 Camp Woods Rd, Villanova, PA 19085.

Abstract

Peripheral nerve blocks at the ankle have long been used for foot surgery. However, when local foot and ankle blocks are inappropriate or contraindicated, general and spinal anesthesia are the common alternatives. Both have disadvantages and require added equipment and monitors. Combined popliteal and saphenous nerve blocks at the knee can offer a desirable alternative to general and spinal anesthesia for foot and ankle surgery. In addition, popliteal and saphenous nerve blocks provide anesthesia of the entire lower leg, thus permitting a greater variety of procedures to be performed. This article reviews the anatomical considerations, various block techniques, and surgical applications of this useful approach to lower-leg anesthesia. (J Am Podiatr Med Assoc 94(4): 368–374, 2004)






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Copyright © 2004 by the American Podiatric Medical Association.