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Posterior Tibial Nerve Block

Posterior Tibial Nerve Block

Welcome to the Posterior Tibial Nerve Block regional anesthesia page. Here we will cover indications, contraindications, materials and steps for you to master this procedure. Let’s begin with the overview below.Welcome to the Radial Nerve Block regional anesthesia page. Here we will cover indications, contraindications, materials and steps for you to master this procedure. Let’s begin with the overview below.

Overview

The posterior tibial nerve block is a safe, rapid, and effective method to provide analgesia to the calcaneus and plantar area of the foot. The sole of the foot can be a difficult area to anesthetize locally, and the posterior tibial nerve block requires fewer injections and a smaller volume of anesthetic compared to local anesthesia.[1] While this block can be performed using anatomic landmarks, the ultrasound-guided technique is associated with a higher success rate.[2]

Indications

For regional anesthesia to the heel and plantar surface of the foot. Commonly used for acute pain relief for calcaneus fractures as well as analgesia for laceration repair, foreign body removal, and wound exploration or drainage.[3][4]

Contraindications

There are few true contraindications to this block. They include:

  1. Infection (cellulitis) at the site of injection
  2. Allergy to local anesthetic being used
  3. Patient refusal

Some relative contraindications to consider:

  1. Patient needs a neural exam of the affected extremity
  2. Anticoagulation use or bleeding disorder (pressure and tourniquet can be applied to the affected area if necessary)
  3. Patient with prior neural lesion or active injury