Plastic surgery often involves intricate procedures on the legs, requiring careful management of pain and optimal patient comfort. Lower limb nerve blocks play a pivotal role in achieving these objectives. Lower extremity blocks refer to regional anesthesia techniques that involve the administration of local anesthetics to block the sensory nerves supplying the lower extremities. Dallas plastic surgeon Dr. Solomon Azouz uses lower extremity nerve blocks to help with pain during liposuction, lipedema surgery, labiaplasty, thigh lift and reconstructive surgery.
Here are some commonly performed lower limb blocks:
1. Sciatic Nerve Block:
- Location: The Sciatic Nerve, which travels from your lower back through your hips and buttocks and down each leg, is the largest nerve in the human body.
- Procedure:The Sciatic Nerve Block involves injecting a local anesthetic near the sciatic nerve, often with or without a corticosteroid for long-term pain relief. The goal is to obstruct nerve impulses, which keeps the brain from receiving pain signals. There are several methods to perform a sciatic nerve block, and the choice of approach depends on the patient’s anatomy, the surgical site and Dr. Azouz’s recommendation.
- Examples: thigh lifts, liposuction and lipedema surgery
2. Femoral Nerve Block:
- Location: The Femoral Nerve is located in the pelvis and goes down the front of the leg. It controls movement and sensory feeling in the hips and legs.
- Procedure: Pain signals from the lower limb are temporarily stopped from reaching the brain through the administration of the nerve block. A local anesthetic, such as lidocaine or bupivacaine, is injected at the skin level to minimize discomfort during the procedure.
- Examples: thigh contouring, knee lifts, liposuction and lipedema surgery
3. Popliteal Nerve Block:
- Location: The Popliteal Nerve is a lower leg nerve that provides sensation to the knee joint and the posterolateral section of the leg.
- Procedure: Dr. Azouz will administer a local anesthetic close to the popliteal fossa in order to block the sensory nerves supplying the posterior knee and calf. The sciatic nerve is the primary nerve impacted by a popliteal nerve block. The popliteal nerve block is helpful for a variety of surgical and pain management procedures because it blocks these sciatic nerve branches, which in turn provides analgesia to the posterior knee and calf.
- Examples: calf implants removal, liposuction and lipedema surgery
4. Tibial Nerve Block:
- Location: The majority of the posterior leg and foot are controlled by the tibial nerve, one of the two sciatic nerve terminal branches, that provides motor and sensory function.
- Procedure: In order to block sensory signals and provide analgesia to the posterior area of the leg and the sole of the foot, Dr.
- Examples: calf implant removal, liposuction and lipedema surgery
5. Saphenous Nerve Block:
- Location: The saphenous nerve is a sensory nerve that arises from the femoral nerve, and provides stimulus to the skin of the medial part of the leg and foot. It travels down the thigh, crosses the knee joint, and descends along the medial side of the leg into the foot.
- Procedure: A local anesthetic, such as lidocaine or bupivacaine, is injected near the saphenous nerve using ultrasound guidance.
- Examples: liposuction and reconstructive surgery
6. Obturator Nerve Block:
- Location: Through the anterior division’s terminal branch, the obturator nerve regulates the skin of the central region of the upper thigh. Additionally, it gives the lower leg’s adductor muscles motor sensation.
- Procedure: Dr. Azouz will inject close to the obturator nerve during an obturator nerve block to momentarily stop its function. This will reduce pain in the obturator nerve’s supplied areas, which makes it helpful for surgeries or illnesses affecting the hip, inner thigh, or pelvis.
- Examples: Thigh lifts and lipedema surgery
7. Pudendal Nerve Block:
- Location: A Pudendal Nerve Block involves the injection of medication into the pudendal nerve to provide relief from pain or discomfort in the pelvic area. The pudendal nerve is a major nerve in the pelvic region that supplies sensation to the external genitalia, perineum (area between the anus and genitals), and the rectal area.
- Procedure: A local anesthetic, often combined with a corticosteroid for prolonged relief, is injected near the pudendal nerve to block pain signals.
- Examples: Body Contouring Surgery and Labiaplasty
Lower limb nerve blocks offer several advantages, including improved pain control, reduced opioid use, and quicker recovery. The choice of a specific nerve block depends on the surgical procedure, patient characteristics, and the preferences of the anesthesia and surgical teams. It’s important to note that in addition to nerve blocks, other types of anesthesia may be required to enhance overall pain management and reduce potential side effects associated with opioids. This will depend on the type of surgery, patient characteristics, and the expertise of Dr. Azouz.
During your consultation, Dr. Azouz will discuss a personalized surgical plan that includes controlling pain during and after your procedure. If you are interested in surgery to improve the contour of your legs, call the office at (972) 702-8888 to schedule a consultation with board-certified plastic surgeon Dr. Azouz in Dallas. Dr. Azouz also offers virtual consultations for patients who are considering traveling to Dallas for plastic surgery.
Written by Anika Patel and Rhiya Patel on behalf of Azouz Plastic and Cosmetic Surgery
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