Ultra Sound Guided Ankle Block Versus Sciaticofemoral Block for Anesthesia and Postoperative Analgesia In Diabetic Foot Surgery

Abstract

An infected diabetic foot ulcer is by far the most common form of soft tissue infection encountered in clinical practice. It is caused by direct invasion of the ulcer and the underlying soft tissues by bacterial inoculum. The foot is innervated by five nerves - the posterior tibial (PTN), superficial peroneal, deep peroneal and sural nerves (which originate from the sciatic nerve) and the saphenous nerve (a branch of the femoral nerve). The superficial peroneal, sural and saphenous nerves have a purely cutaneous distribution, and are blocked by simple subcutaneous infiltration in the appropriate location. In contrast, the PTN and deep peroneal nerves innervate deep structures, including both bone and muscle. Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage". The single greatest benefit of the use of ultrasound for peripheral nerve blocks is the ability to visualize of the needle throughout the performance of the block and adequate visualization of the needle is mandatory for safe and effective blocks by preventing block complications such as, hematoma formation, improper block or intravascular injection. Close