Sural nerve :
Introduce the needle along the lateral border of the Achilles tendon at the level of the cephalic border of the lateral malleolus.Advance anteriorly towards the fibula.If parasthesia is felt inject 3-5ml LA. If not, inject 5-7ml LA as the needle is withdrawn. This gives subcutaneous infiltration from the Achilles tendon to the fibula.

Infiltration around the remaining three nerves can be performed from a single site. The needle is inserted 1cm lateral to the tendon of extensor hallucis longis (or just lateral to the anterior tibial artery, if palpable), at the level of the cephalic borders of the malleoli. This tendon is prominent on the dorsum of the foot, during extension of the big toe.

Deep peroneal nerve :
From the position described above, advance the needle posteriorly (i.e. at 90¡ to the skin). Inject 3-5ml LA deep to the fascia, on either side of the anterior tibial artery.

Superficial peroneal nerve :
After blocking the deep peroneal nerve, withdraw the needle to just stay in the skin.
Turn the needle towards the lateral malleolus and inject 5ml LA in a subcutaneous band between the lateral malleolus and the anterior border of the tibia. This should reach all the branches of this nerve.

Saphenous nerve :
Again withdraw the needle to just stay in the skin and turn the needle to point towards the medial malleolus.Infiltrate 5ml LA subcutaneously as the needle is advanced towards the medial malleolus. The great saphenous vein lies in this area, just antero-medial to the medial malleolus, in order to infiltrate around the vein, without causing damage, it may be necessary to make a further skin puncture lateral to the vein.