UMEM Educational Pearls

Title: Ultrasound Guided Posterior Tibial Nerve Block

Category: Ultrasound

Keywords: ultrasound, nerve block (PubMed Search)

Posted: 3/11/2024 by Alexis Salerno, MD
Click here to contact Alexis Salerno, MD

What happens if you have a patient who steps on a nail? How can you make this procedure easier for you and the patient?

– Use a Posterior Tibial Nerve Block! !

To Perform This Procedure:

Have the patient lay on a stretcher and externally rotate their hip and have their knee flexed.
Clean the area
Use a linear probe with a sterile probe cover on
Place the probe with the marker towards the patient’s right, just above the medial malleolus and positioned posteriorly.
Identify the posterior tibial nerve next to the posterior tibial artery and center the probe on the nerve
Use a 22–30-gauge needle in an out of plane technique, slowly inject about 5 cc of anesthetic, making sure you are just above the nerve and not in the artery.