Continuous popliteal sciatic nerve block for outpatient foot surgery--a randomized, controlled trial

Area of Science:

• Anesthesiology
• Pain Management
• Surgical Procedures

Background:

• Outpatient foot surgery frequently results in severe postoperative pain.
• Oral analgesics often provide insufficient pain relief for these patients.

Purpose of the Study:

• To evaluate the efficacy of continuous sciatic nerve blockade in managing postoperative pain after ambulatory foot surgery.
• To assess the safety and impact on pain and sleep disturbances.

Main Methods:

• Sixty-three patients undergoing foot surgery received spinal anesthesia.
• Sciatic and saphenous nerve blocks were performed post-surgery, with a continuous ropivacaine infusion via a perineural catheter in the popliteal fossa.
• Patients were randomized to receive either ropivacaine or saline infusion for 55 hours.

Main Results:

• Continuous sciatic nerve blockade provided prolonged analgesia, significantly reducing pain on postoperative days one and two.
• While initial analgesia duration was similar, the treatment group experienced less pain thereafter.
• Sleep disturbances due to pain were reduced in the treatment group, with no difference in rescue opioid use or adverse effects.

Conclusions:

• Continuous sciatic nerve blockade in the popliteal fossa is an effective method for reducing postoperative pain after ambulatory foot surgery.
• The technique demonstrated a favorable safety profile with no significant adverse events.
• This approach offers a promising solution for managing severe pain in patients undergoing ambulatory foot surgery.