• Viviane de Oliveira Rangel, Raphael de Almeida Carvalho, Beatriz Lemos da Silva Mandim, Rodrigo Rodrigues Alves, Roberto Araújo Ruzi, and Neuber Martins da Fonseca.
• Universidade Federal de Uberlândia, Brazil. olirangelbr@yahoo.com.br
• Rev Bras Anestesiol. 2011 Sep 1;61(5):533-43, 293-8.

Background And ObjectivesTechniques of peripheral nerve block have gained popularity over the last two decades becoming a growing anesthetic option for limb surgeries. This study proposes a technical approach of the tibial and common fibular nerves in the popliteal fossa with single puncture using percutaneous nerve stimulator, considering the correlation with an anatomical and ultrasound study.MethodsThis prospective, observational, randomized study was performed with 28 patients scheduled for foot surgeries. After localizing the tibial and common fibular nerves through percutaneous stimulation, the puncture was performed at the point of tibial nerve stimulation with a 5-cm needle (B.Braun, Stimuplex 50), and 10 mL of levobupivacaine were injected. The needle was pulled back and redirected to the point of common fibular nerve stimulation looking for the corresponding motor response, and 10 mL of the local anesthetic were injected. Imaging study of the popliteal region was performed by ultrasound to correlate the anatomy with the technique used.ResultsAdequate anesthesia was obtained in all cases. The mean time to localize the tibial and common fibular nerves suing the percutaneous stimulator was 57.1 and 32.8 seconds, respectively, and with the nerve stimulator it was 2.22 and 1.79 minutes, respectively. The mean depth of the needle into the tibial nerve was 10.7 mm.ConclusionsThe approach for tibial and common fibular nerves with single puncture in the popliteal fossa using peripheral nerve stimulator is a good option for anesthesia and analgesia for foot surgeries.Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

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