Ultrasound does not improve the success rate of a deep peroneal nerve block at the ankle

The deep peroneal nerve is 1 of 5 nerves anesthetized when performing an ankle block. Multiple techniques of blocking the deep peroneal nerve have been described, but little evidence exists to delineate the efficacy of any one technique. We hypothesized that ultrasound would increase both the succes...

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Bibliographic Details
Published in:	Regional anesthesia and pain medicine Vol. 35; no. 2; pp. 217 - 221
Main Authors:	Antonakakis, John G, Scalzo, David C, Jorgenson, Aric S, Figg, Katie K, Ting, Paul, Zuo, Zhiyi, Sites, Brian D
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group LTD 01-03-2010
Subjects:	Adult Ankle Female Humans Male Middle Aged Movement - drug effects Movement - physiology Nerve Block - instrumentation Nerve Block - methods Nerve Block - standards Peroneal Nerve - diagnostic imaging Prospective Studies Regional anesthesia Sensation - drug effects Sensation - physiology Single-Blind Method Thermosensing - drug effects Thermosensing - physiology Ultrasonic imaging Ultrasonography, Interventional Young Adult
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Summary:	The deep peroneal nerve is 1 of 5 nerves anesthetized when performing an ankle block. Multiple techniques of blocking the deep peroneal nerve have been described, but little evidence exists to delineate the efficacy of any one technique. We hypothesized that ultrasound would increase both the success rate and the quality of a deep peroneal nerve block at the ankle. Eighteen healthy volunteers participated in this randomized, controlled, prospective study. Each subject was randomly assigned to receive an ultrasound-guided deep peroneal nerve block of either the right or the left ankle. The deep peroneal nerve on the opposite side was blocked using a conventional landmark technique. Subjects were blinded to the technique used. All blocks were preformed with 5 mL of 3% 2-chloroprocaine. We evaluated both sensory and motor blocks at 10-min intervals for 60 mins. Blocks were maximal in both groups at 20 to 30 mins. There was a statistically significant difference in temperature sensation and motor function at 10 mins favoring the ultrasound group. There was no statistical difference in motor function, temperature, or pinprick sensation between 20 and 60 mins. The use of ultrasound seems to improve the onset of deep peroneal nerve block at the ankle but does not improve the overall quality of the block.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1098-7339 1532-8651
DOI:	10.1097/AAP.0b013e3181c75db1