Anesthesia for ankle and foot surgery

The peripheral location of the surgical site in foot and ankle surgery and the possibility to block the pain pathways at multiple levels present a clear advantage of regional anesthesia in this setting. Several highly efficacious regional anesthesia techniques can be used to provide excellent operating conditions and low incidence of perioperative complications. Regional anesthesia techniques are also well suited for management of postoperative pain after foot and ankle surgery. In order to deliver anesthesia in a safe, efficient, and competent manner, the selection of a regional anesthetic must be based on the site, degree, and duration of the operation, requirement for ambulation, and on the requirement for pain control in the postoperative period. In this review we discuss some anatomic considerations for proper selection of regional anesthesia techniques for foot and ankle surgery and describe some new peripheral nerve blockade techniques suitable for these operations.

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