The efficacy of combined popliteal and ankle blocks in forefoot surgery

J Bone Joint Surg Am. 2008 Jul;90(7):1443-6. doi: 10.2106/JBJS.G.01133.

Abstract

Background: Postoperative pain following forefoot surgery can be difficult to control with oral analgesia. The aim of this study was to compare the efficacy of a combined popliteal and ankle block with that of an ankle block alone in providing postoperative analgesia following forefoot surgery.

Methods: We performed a prospective, randomized, controlled single-blind study involving sixty-three patients, twenty-six of whom had a combined ankle and popliteal block and thirty-seven of whom had an ankle block alone. All patients underwent an elective osseous surgical procedure on the forefoot. Postoperative pain was evaluated with use of a visual analogue scale and a verbal response form. Patient satisfaction was also recorded.

Results: The patients who had had a combined popliteal and ankle block had significantly less pain at six hours postoperatively (p = 0.011), twenty-four hours postoperatively (p < 0.001), and at discharge (p = 0.014). This group of patients also had higher satisfaction with pain relief.

Conclusions: A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ankle
  • Female
  • Forefoot, Human / surgery*
  • Humans
  • Knee
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Orthopedic Procedures
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Patient Satisfaction
  • Prospective Studies
  • Single-Blind Method
  • Treatment Outcome