Safety and efficacy of forefoot surgery under ankle block anaesthesia

Ankle block as the sole anaesthetic for forefoot surgery is not used uniformly throughout the UK despite obvious advantages and widespread use internationally.

Evaluation of safety and effectiveness of performing elective forefoot surgery under ankle block anaesthesia alone in a pilot cohort of patients in a Scottish unit.

Data were collected from 81 consecutive forefoot procedures (71 patients) using a standardised questionnaire including incremental pain assessment (0-10; 0 no pain, 10 severe pain).

Seven patients reported pain during surgery; average score 0.17. Average pain scores 6, 12, 24 and 48 h following surgery were 1.5, 3.09, 2.3 and 1.9, respectively. All patients were discharged home and walking on the same day.

Forefoot surgery under ankle block alone may be safe and effective. Anaesthesia obtained permitted routine forefoot procedures and provided lasting post-operative analgesia. Combined with intra-operative sedation, use of ankle tourniquet and same day discharge, it had very high patient acceptance and satisfaction.