Bilateral ankle blocks: a prospective audit.

Area of Science:

• Anesthesiology
• Surgical Procedures
• Pain Management

Background:

• Bilateral ankle blocks offer significant advantages but face clinician reluctance due to concerns about reliability, anesthetic duration, toxicity, surgical efficiency, and patient comfort.
• Addressing these concerns is crucial for wider adoption of this anesthesia technique.

Purpose of the Study:

• To audit the efficacy and safety of bilateral ankle blocks in patients undergoing mid- and forefoot surgery.
• To evaluate local anesthetic safety, efficacy, and patient acceptance.
• To determine the success rate of bilateral ankle blocks.

Main Methods:

• An audit of 66 patients undergoing bilateral ankle blocks for mid- and forefoot surgery.
• Administration of intravenous sedation during block insertion and intraoperatively as needed.
• Use of three local anesthetic combinations: lignocaine/ropivacaine, ropivacaine alone, or ropivacaine/clonidine.

Main Results:

• An 89% success rate was achieved for bilateral ankle blocks.
• The ropivacaine and clonidine combination provided the longest duration of action (17 hours), followed by ropivacaine alone (14 hours) and the ropivacaine and lignocaine combination (8 hours).
• No adverse local anesthetic events were reported, and 61% of patients recalled intraoperative events with high overall acceptance.

Conclusions:

• Bilateral ankle blocks are a safe and efficient anesthetic technique for foot surgery.
• Appropriate use of sedative drugs ensures patient comfort during block insertion and surgery.
• The study supports the clinical utility of bilateral ankle blocks when managed with adequate sedation.