Compartment block for foot surgery. A new approach to tibial nerve and common peroneal nerve block

Abstract

Background and objectives: The concept of single injections of local anesthetics into fascial compartments was pioneered by Winnie in reports on paravascular techniques. Winnie described an axillary approach for brachial plexus block and the inguinal route for lumbar plexus block. The compartmental principle can, with advantage, be extended to more peripheral anesthesia of the tibial and common peroneal nerves by the use of osteofascial compartments in the leg.

Methods: A brief description of the relevant anatomy is followed by the method and results of a study designed to test the ease of performance and efficacy of these techniques for 20 healthy patients scheduled for foot surgery.

Results: The new blocks were easy to perform and the patients experienced prolonged postoperative analgesia probably due to confinement of the local anesthetic in enclosed compartments.

Conclusions: Further studies of compartmental anesthesia for other nerve trunks and plexuses may be of value.