Complications of Posterior tibial nerve block and Prevention 1. Infection at site of injection – Prevent by maintaining hygiene of site of injection and choose sterile technique. 2. Ischemia – Be attentive to the landmarks to prevent intra-arterial puncture. 3. Systemic toxicity - Be attentive to the landmarks to prevent intra-venous puncture and aspirate to ensure no puncture. 4. Parasthesia – Pull back slightly to prevent direct injection of nerve. 5. Hematoma formation – Manage by maintaining pressure and elevation. 6. Allergic reaction to anesthetic agents – Manage by using an alternative.