Ultrasound-assisted and evoked motor response stimulation of the deep peroneal nerve.

Abstract

We performed an observational volunteer study to document an ultrasound-guided evoked motor response blockade of the deep peroneal nerve. Sixteen volunteers had deep peroneal nerve blocks in each foot. After visualization of the artery and the deep peroneal nerve with an ultrasound, the nerve was stimulated with a nerve stimulator. Evoked motor responses and/or paresthesia were noted before injection of the local anesthetic. Any evoked motor response (extension of the toes or muscle contractions on the dorsum of the lateral aspect of the foot) or elicitation of paresthesia resulted in complete sensory blockade of the web between the big toe and second toe. Visualization of the deep peroneal nerve with ultrasound followed by elicitation of an evoked motor response, or paresthesia, predicts successful blockade of the deep peroneal nerve.