A comparison of ultrasound guided and nerve stimulator assisted popliteal nerve blocks for foot surgery

INTERVENTION: Ultrasound nerve localization with a Sonosite Nanomaxx ultrasound system using an L38n ultrasound probe in the 5‐10MHz range or Once the nerves have been adequately localized in the transverse plane below the level of the bifurcation. A double injection ‐ a block of the Common Peroneal nerve and Posterior Tibial nerve is performed, the saphenous nerve is also blocked at the level of the knee The local anaesthetic agent used is 20ml of Ropivicaine 0.75% The block is inserted prior to prepping and draping CONDITION: Pain relief during and after foot surgery PRIMARY OUTCOME: Post procedure analgesic requirements. The analgesic and dose will be recorded on a form by the anaesthetist intraoperatively and by nursing staff in recovery and then on the ward SECONDARY OUTCOME: Patient satisfaction Residual neurological deficit at 8 weeks Speed to perform block Time to onset before 4 hours INCLUSION CRITERIA: Foot Surgery which will last <90 mins and require an overnight stay. Calf tourniquet >18 yrs American Society of Anesthesiologists (ASA) score I ‐ III