What is a posterior tibial nerve block?

Updated: Jun 14, 2018
  • Author: Heather Tassone, DO; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Posterior tibial nerve block allows for rapid anesthetization of the heel and plantar regions of the foot. Practitioners in the emergency department frequently encounter patients who have sustained trauma to the sole of the foot and require regional anesthesia for repair. However, this tender area is relatively difficult to anesthetize locally.

Posterior tibial nerve block is often overlooked in the emergency department, although it is safe, relatively easy to perform, and can provide excellent anesthesia to the foot. [1] In one study, regional anesthesia of the foot and ankle, when performed by surgeons, was completely successful 95% of the time. [2]

Regional blocks have several advantages compared to local infiltration, such as fewer injections necessary to attain adequate anesthesia, smaller volume of anesthetic required, and less distortion of the wound site. [3, 4, 5] Because of the lower number of injections, this procedure is better tolerated by the patient and limits the chance of a needle stick to the provider.

For more information on pain management, see Medscape's Pharmocologic Management of Pain Resource Center.

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