Nerve injury following popliteal nerve and adductor canal blocks: A case series

• Published in: Foot & ankle surgery (New York, N.Y.) Vol. 2; no. 4; p. 100231
• Main Authors: Black, Alexandra T., Stone, Ryan, Steginsky, Brian, Strakowski, Jeffrey A., Logan, Daniel
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 2022; Elsevier
• Subjects: Adductor canal block; Drop foot; Foot and ankle surgery; Paresthesia; Popliteal nerve block; Regional anesthesia; NCV; Popliteal nerve block; Regional anesthesia; Adductor canal block; Foot and ankle surgery; Drop foot; Paresthesia; EMG; US
• ISSN: 2667-3967; 2667-3967
• DOI: 10.1016/j.fastrc.2022.100231

Popliteal nerve blocks are a common form of operative and postoperative regional analgesia for procedures involving the knee, ankle, and foot. This widely used analgesic technique comes with possible neuropathic complications, which remain unknown. In this paper, we review 7 consecutive patients that presented with popliteal/saphenous nerve block complications after foot and ankle surgery. One of the patients developed foot drop, requiring an AFO followed by tendoachilles lengthening and posterior ankle capsular release. The remaining patients reported dysesthesia and painful symptoms. Only 2 out of the 7 patients resulted in symptoms that resolved at the time of publication. The authors hope to provide insight into the potential risks and complications associated with this form of regional anesthesia. It is essential for surgeons to inform patients of the potential risks and propose alternative methods for postoperative pain management as deemed necessary. Further prospective studies are necessary to determine the impact of multiple factors, including ultrasound-guidance versus nerve stimulation, repetitive ipsilateral nerve blocks, adjunct adductor canal blocks, and tourniquet use.