Superficial peroneal nerve blockade is used to diagnose and treat pain disorders of the superficial peroneal nerve distribution in the foot.
After informed consent is obtained, the patient is placed in a supine position with the foot elevated on a pillow. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1-in. (2.5- cm), 25-gauge needle is inserted just laterally to the anterior border of the tibia at the proximal level of the lateral malleolus. The needle is carefully advanced to the superior aspect of the lateral malleolus. After negative aspiration, 5 mL of local anesthetic is injected over the course of the needle to block all the branches of the superficial peroneal nerve (see Fig. 67-19).
FIGURE 67-19. Nerve blocks at the ankle. Approach for nerve injection and neural blockade at the ankle.
The superficial peroneal nerve exits the deep fascia of the leg at the anterior aspect of the distal two thirds of the leg. From that point, the superficial peroneal nerve runs subcutaneously to supply the dorsum of the foot and toes, with the exception of the contiguous surfaces of the great and second toes.
Complications are rare with the superficial peroneal nerve block.