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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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Chapter 17 – Ankle Block


The ankle block is often used for surgical procedures carried out on the foot, especially for those not requiring high lower leg tourniquet pressure.

Patient Selection.

The ankle block is principally an infiltration block and does not require elicitation of a paresthesia. Thus, patient cooperation is not mandatory for successful use of the block. Although the block is most efficient for the anesthesiologist if the patient can assume the prone as well as the supine position, this is not essential for performance of the block.

Pharmacologic Choice.

Because motor blockade is not often needed for procedures carried out during ankle block, lower concentrations of local anesthetics may be utilized. Practical choices are 1% lidocaine, 1% mepivacaine, 0.25% to 0.5% bupivacaine, and 0.2% to 0.5% ropivacaine. Many workers suggest that epinephrine should not be used during ankle block, especially if injection is circumferential.

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