Comparison of lateral versus posterior approach of popliteal nerve block for diabetic foot surgeries

Abstract

Patients with long duration of diabetes are more prone for multi system disorders and compromised physiological state. Diabetic foot surgeries are mostly performed under regional nerve blockade, which does not interfere much with normal physiology. Popliteal block is a rapid, effective and safe anaesthesia for foot surgery or for pain relief after foot surgery. In this block the sciatic nerve is blocked in the area of the popliteal fossa. The classic posterior approach is anatomically reliable and provides good results. The main disadvantage of the posterior approach to the block of the sciatic nerve in the popliteal fossa is the need to place the patient in the prone position. This may preclude use of posterior block patients who could benefit most from this technique i.e. those with morbid obesity, spine problems and hemodynamic instability. Sciatic nerve in the popliteal fossa can also be reliably ascessed in supine position using lateral approach. This study shows that the lateral approach that is performed with the patient in supine position is as effective and safe, as the classical posterior block.