Peripheral nerve block for foot and ankle surgery

At Parkside Orthopaedics and Sports Medicine Centre, our expert team perform foot and ankle surgery in four modern operating theatres. In many cases, we can offer you an injection called a peripheral nerve block. This gives you temporary pain relief during and after an operation.

What is a peripheral nerve block?

The peripheral nerves are the nerves outside your brain and spinal cord. They send information between your brain and the rest of your body.

A peripheral nerve block involves injecting a numbing medicine called a local anaesthetic and other painkillers near the main nerves to your leg. This temporarily blocks the nerves from sending pain messages to the brain. Pain can be blocked for up to 18 hours.

Why might I need a peripheral nerve block?

We often use a peripheral nerve block during foot and ankle surgery. A specialist anaesthetist gives you an injection to make your foot and ankle numb for a temporary period. The injection stops you from feeling any pain during the operation and gives you extra pain relief afterwards.

You may have the injection in the foot or ankle, behind the knee or thigh or near the groin. This depends on what operation you have. Two types of peripheral nerve blocks commonly used in foot and ankle surgery are:

  • Ankle block: You have an injection around your ankle to make your foot numb.
  • Popliteal nerve block: You have an injection at the back of your knee to make your lower leg, foot and ankle numb.

A peripheral nerve block can sometimes be used instead of a general anaesthetic, which sends you to sleep during an operation. In this case, you are often sedated as well. This means that you are given a drug to make you feel drowsy and more relaxed.

Otherwise, you may have a peripheral nerve block with a general anaesthetic or spinal anaesthetic (which makes you numb from the waist downwards). The nerve block is intended to reduce your pain and make you feel more comfortable for the first night after your operation.

What are the benefits and risks of having a peripheral nerve block?

A peripheral nerve block is very safe for most people. It is not suitable if you have some medical conditions, such as a blood-clotting disorder, or take certain medicines.

Before you have a foot and ankle operation, we ask you to attend a pre-operative assessment clinic. We assess your general health, review your medical history and discuss what type of anaesthetic suits you best.

We also fully explain the benefits and any risks of having a peripheral nerve block. There are many benefits, including:

  • Better pain relief: A peripheral nerve block gives you effective pain relief during and straight after an operation. This means that you are less likely to need strong painkillers, which can make some people feel sick or sleepy.
  • Avoiding a general anaesthetic: Some operations can be carried out with a peripheral nerve block alone. You can then avoid the risks and side effects of a general anaesthetic.
  • Faster recovery: If your pain is well controlled with a peripheral nerve block, you may recover more quickly after your operation. You may be able to leave hospital sooner.

What is the procedure for having a peripheral nerve block?

At Parkside Orthopaedics and Sports Medicine Centre, we are committed to giving you the best possible care. Your anaesthetist explains the procedure for a peripheral nerve block. You may have a sedative, which makes you calm and relaxed during the procedure.

The anaesthetist puts a small plastic tube called a drip or cannula into a vein of your hand or arm. They attach routine equipment to monitor your heart rate, blood pressure and breathing. An assistant helps you to get into position for the anaesthetic injection.

Next, the anaesthetist cleans your skin and makes the area to be injected numb with a small amount of local anaesthetic. They use an ultrasound machine and nerve stimulator to find the correct place for the injection. A nerve stimulator is a little machine that makes your leg muscles twitch.

The anaesthetist carefully injects the local anaesthetic around your nerves with a fine needle. This injection temporarily makes your nerves numb. You should only feel slight discomfort during the injection. Occasionally, the anaesthetist leaves a small tube in place near the nerves. More local anaesthetic can then be injected over a longer period, if needed.

What happens after having a peripheral nerve block?

After having the injection, your foot or leg soon starts to feel warm, tingly and numb. It takes about 30 minutes for the peripheral nerve block to work fully. Your anaesthetist checks that the block has been effective before your operation.

The peripheral nerve block can provide pain relief for up to 18 hours after your operation. We give you advice on how to look after your foot or ankle and move safely until the local anaesthetic wears off.

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A peripheral nerve block is a method of pain relief, which has various benefits during foot and ankle surgery. It can help you feel more comfortable while you recover.

Parkside Orthopaedic and Sports Medicine Centre provides first-class independent healthcare. To make an appointment with a foot and ankle consultant, please call 020 3944 0568 or complete this form online. Appointments are available six days a week.

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