Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

Abstract

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

Ultrasound-guided popliteal plexus block versus fascia iliaca block for postoperative analgesia after total knee arthroplasty: a randomized clinical trial

“…26 Also, Kim et al reported that PPB demonstrated less pain, extended sensory block duration, and fewer repeated injections compared to DB. 28 Our results showed that both groups had comparable PONV, hypotension, and bradycardia. PONV occurred in 8 (26.67%) patients in PPB group and 3 (10%) in FIB group.…”

Ingrown Toenail Management Across Mental Health and Other Health Facilities in Nigeria: A Review of Anesthetic and Surgical Management

“…Elsewhere, the anesthetic techniques were well defined. Kim and colleagues [13] talked about the use of short-acting lidocaine in ultrasound-guided popliteal nerve block for ingrown toenail surgical therapy. Nevertheless, digital blocks containing non-epinephrine local anesthetic drugs are also Prospective study Patients (25%) who had conservative treatment and avulsion of the nail had recurrence.…”

“…The surgeries are amenable to various anesthetic techniques. Kim and colleagues [13]. discussed using ultrasoundguided popliteal nerve block using short-acting lidocaine in the surgical treatment of ingrown toenails.…”