Question

Regional anesthesia at which of the following locations would provide adequate analgesia for surgery at the ankle? A. Injection lateral to the femoral artery, and injection inferolateral to the pubic symphysis

B. Injection in the fascial plane between the vastus medialus and sartorius, and injection at the popliteal fossa
C. Injections in the intermuscular fascial planes between the adductor brevis and adductor longus, and between the adductor brevis and adductor magnus
D. Injection medial to the femoral artery, and injection at the popliteal fossa
E. Injection in the psoas compartment, and injection between the vastus medialis and sartorius

Answer 1

Adequate analgesia for ankle surgery is achieved through a popliteal fossa block combined with a saphenous nerve block, which is correctly represented by option D.

Step-by-step explanation:

Regional anesthesia for surgery at the ankle can be achieved through various nerve blocks, of which the correct option to provide adequate analgesia is: Injection at the popliteal fossa in conjunction with a saphenous nerve block. The popliteal fossa block desensitizes the tibial nerve, common fibular (peroneal) nerve, and sometimes the sural nerve and posterior cutaneous nerve of the thigh, covering a large part of the sensory innervation around the ankle. The saphenous nerve, as a branch of the femoral nerve, is blocked with an injection near the femoral triangle region or along the course of the nerve. For completeness, an answer to the original multiple-choice options: D. Injection medial to the femoral artery, and injection at the popliteal fossa would be the most appropriate because the femoral part of the block targets the saphenous nerve.