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Background and Aims Performing non-obstetric surgery on pregnant patients is a challenging task for non-obstetric anaesthesiologists. The primary objective is to ensure safety of both the mother and the fetus. It is crucial to avoid the use of dangerous drugs, hypoxia, and hypotension while maintaining adequate uteroplacental perfusion. Regional anaesthesia plays significant role in reducing neuroendocrine response to stress and the need for opioids and systemic analgesics.

Case report A 21-year-old pregnant patient in her 37th week of gestation was admitted for surgery on a fractured ankle joint. The anaesthesia plan included administering a femoral and popliteal nerve block with moderate sedation. The patient was placed in lateral position, and an ultrasound-guided popliteal block was performed. The block included the tibial nerve, and the common peroneal nerve, and 15ml of levobupivacaine 0.5% and 10ml of lidocaine 1.3% were injected. The patient was then placed in supine position, and a proximal saphenous block was performed by infiltrating 10 ml of levobupivacaine 0.5%. Blockade of the saphenous nerve achieved anaesthesia for cutaneous medial leg and ankle joint capsule. The combination of these regional block techniques provided complete anaesthesia below the knee.

Conclusions The multidisciplinary approach is essential for the safety of pregnant patients undergoing non-obstetric surgery. This team should include an obstetrician, an anaesthesiologist, a surgeon, and a perinatologist. The anaesthesia and postoperative analgesia should be well-planned to ensure the safety of both the mother and the fetus. A popliteal nerve block with addition of a femoral block provides adequate anaesthesia for ankle surgery.