{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T16:37:06Z","timestamp":1793291826101,"version":"4.5.0"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,8,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Regional anesthesia for foot surgery commonly relies on a five-injection ankle block, a technique associated with technical complexity and patient discomfort. We developed an ultrasound-guided five-in-two (FIT) ankle block based on an anatomical rationale, to provide complete foot anesthesia with only two punctures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A dual-injection ankle block technique was defined through an anatomical study, consisting of a mid-calf injection targeting the superficial and deep fibular nerves and a distal transverse injection 5\u2009cm above the medial malleolus targeting the tibial, saphenous, and sural nerves. The technique was assessed in a bicentric prospective observational study of adult patients undergoing outpatient foot surgery, with surgical anesthesia as the primary outcome. Secondary outcomes assessed block performance, perioperative pain intensity, 24-hour rescue analgesic consumption, patient-reported experience, and block-related safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>80 patients received a FIT ankle block, with successful surgical anesthesia achieved in 77 cases (96%). Median sensory and motor block durations were 554 (420\u2013758) and 600 (444\u2013882) minutes, respectively. Pain was minimal, with median Visual Analogue Scale scores of 0 (0\u20137) during block placement and 0 (0\u20134) on arrival in the post-anesthesia care unit. Intravenous rescue analgesia was required in 5% of patients. The median Echelle du V\u00e9cu de l\u2019Anesth\u00e9sie LocoR\u00e9gionale global score was 88 (80\u201397), and the complication rate was 0% (95% CI 0 to 3.75%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The anatomically guided FIT ankle block is an effective proximal motor-sparing regional anesthesia technique for outpatient foot surgery, providing reliable anesthesia, excellent analgesia, and well-tolerated perioperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-108097","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:55:18Z","timestamp":1787147718000},"page":"rapm-2026-108097","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["The five-in-two (FIT) ankle block for outpatient foot surgery: a proof-of-concept anatomical and observational study"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct06882109","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6885-2587","authenticated-orcid":false,"given":"Lucas","family":"Deffontis","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France"},{"name":"Inserm Unit 1298, Montpellier NeuroSciences Institute, Montpellier University, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Herteleer","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Lille University School of Medicine, Lille, France"},{"name":"Department of Anesthesiology, Critical Care and Perioperative medicine, Lille University Hospital, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corentin","family":"Roger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Choquet","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-4521","authenticated-orcid":false,"given":"Mathieu","family":"Capdevila","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Saint Eloi University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayan","family":"Hebrard","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Traumatology, Saint-Jean Sud De France Clinic, Saint-Jean-De-V\u00e9das, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Gourari","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Saint-Jean Sud De France Clinic, Saint-Jean-de-V\u00e9das, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Bonnal","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Saint-Jean Sud De France Clinic, Saint-Jean-de-V\u00e9das, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Bringuier","sequence":"additional","affiliation":[{"name":"Desbrest Institute of Epidemiology and Public Health, Montpellier University, Montpellier, France"},{"name":"Department of Medical Statistics, Montpellier University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9791-8779","authenticated-orcid":false,"given":"Xavier","family":"Capdevila","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France"},{"name":"Inserm Unit 1298, Montpellier NeuroSciences Institute, Montpellier University, Montpellier, France"},{"name":"College of Health Sciences, VinUniversity and Vinmec Healthcare System, Ha Noi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"2026081906551063000_rapm-2026-108097v1.1","doi-asserted-by":"crossref","first-page":"732","DOI":"10.3113\/FAI.2010.0732","article-title":"Current concepts review: regional anesthesia for foot and ankle surgery","volume":"31","author":"Pearce","year":"2010","journal-title":"Foot Ankle 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