Ultrasonography-guided Peripheral Nerve Blocks in Orthopedic Lower Extremity Surgery: A Narrative Review

In orthopedic lower extremity surgeries, peripheral nerve blocks have gained an important place in anesthesia practice, providing perioperative analgesia, reducing opioid consumption, and enabling early mobilization.During hip, knee, ankle, and foot surgeries, various nerve blocks targeting both motor and sensory functions are applied individually based on the anatomy of the surgical area and the patient's characteristics.Femoral nerve block, pericapsular nerve group block, and suprainguinal and infrainguinal fascia iliaca blocks are frequently preferred in hip and proximal femur interventions, while in knee surgeries, the combination of adductor canal block and interspace between the popliteal artery and the capsule of the posterior knee block stands out.In ankle and foot surgeries, adequate anesthesia and analgesia can be achieved by superficially blocking the tibial, peroneal, sural and saphenous nerves.Nerve blocks performed under ultrasonography guidance reduce the risk of failure due to anatomic variations and decrease complication rates.In this review, the main peripheral nerve blocks used in lower extremity orthopedic surgeries, their anatomical basis, indications, complications, and application techniques are evaluated in light of the current literature.