Clinical Significance

A safe and dependable approach for lower extremity anesthesia, blockade of the saphenous nerve can also potentially lessen the need for systemic medication like opioids.

This is especially true when it is carried out under ultrasound supervision.



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Distal Saphenous Nerve

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Distal Saphenous Nerve Block

  • The saphenous nerve can also be blocked farther distally, near the ankle, though ultrasonography often misses the nerve here. 
  • Because of this, a landmark-based technique is more dependable but could need more local anesthetic. 
  • Local anesthetic is injected just above the medial malleolus, 2 cm anterior and posterior to the great saphenous vein, after the medial malleolus and great saphenous vein have been palpated. 
  • In cases where the saphenous vein cannot be felt or seen during an examination, ultrasound guidance is useful. 
  • However, ultrasonography at this level typically does not show the saphenous nerve.

References

and Interesting Articles

  • Arnold C, Alvarado AC, Brady MF. Saphenous Nerve Block. [Updated 2022 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536967/
  • Marsland D, Dray A, Little NJ, Solan MC. The saphenous nerve in foot and ankle surgery: its variable anatomy and relevance. Foot Ankle Surg. 2013 Jun;19(2):76-9. doi: 10.1016/j.fas.2012.10.007. Epub 2012 Dec 27. PMID: 23548446.
  • Walter WR, Burke CJ, Adler RS. Ultrasound-guided therapeutic injections for neural pathology about the foot and ankle: a 4 year retrospective review. Skeletal Radiol. 2017 Jun;46(6):795-803. doi: 10.1007/s00256-017-2624-7. Epub 2017 Mar 16. PMID: 28303298.

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