Clinical Effectiveness of Ultrasound-Guided Popliteal Nerve Block for Foot Surgery: A Retrospective Study

BackgroundRegional anesthesia is central to elective foot and ankle surgery. The popliteal nerve block (PNB) provides extended coverage for midfoot and hindfoot procedures, and ultrasound guidance is postulated to improve block accuracy, safety, and patient comfort.PurposeTo evaluate the clinical effectiveness of ultrasound-guided PNBs in elective foot surgery, focusing on anesthetic success, onset and duration of action, patient tolerance, and postoperative analgesic use.MethodsA retrospective review was conducted of 101 consecutive patients who received ultrasound-guided PNBs in a UK podiatric surgery department between March 2018 and August 2020. Blocks were performed by podiatric surgeons or advanced podiatrists. Outcome measures included onset time of anesthesia (minutes), injection pain assessed using a visual analogue scale (VAS), anesthetic success (adequate anesthesia without top-up), anesthetic failure (complete, tibial, or common peroneal), duration of anesthesia (hours until return of normal sensation), and postoperative analgesic use (days). Descriptive analysis was performed.ResultsThe mean onset time of anesthesia was 21.8 ± 12.2 minutes, and the mean duration was 24.9 ± 11.9 hours. Anesthetic success was achieved in 94 of 101 cases (93.1%), with 7 failures (6.9%) managed using supplementary ankle blocks. The mean VAS pain score during injection was 2.4 ± 1.9 out of 10. Patients required oral analgesia for an average of 4.1 days postoperatively (range: 0-56). No serious complications were reported.ConclusionsUltrasound-guided PNBs provided high success rates, prolonged postoperative analgesia, and good patient tolerance, with no major adverse events. These findings suggest that ultrasound-guided PNBs are a safe and effective regional anesthetic option for elective foot surgery, supporting their role in improving perioperative care and recovery. Prospective comparative studies are recommended to further evaluate their performance against other regional anesthetic techniques.Study DesignRetrospective case series.Level of Evidence4.