Ankle-foot peripheral nerve block for mid and forefoot surgery

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Peripheral nerve blocks offer an alternative to general or spinal anesthesia.
• Effective anesthesia for foot and ankle surgery is crucial for patient outcomes.
• Long-acting anesthetic agents can extend the duration of pain relief.

Purpose of the Study:

• To present a simplified and predictable peripheral nerve block method for the ankle and foot.
• To evaluate the efficacy of this technique for mid and forefoot surgery.
• To assess the duration of analgesia and safety profile of the nerve block.

Main Methods:

• A simplified peripheral nerve block technique targeting specific nerves (posterior tibial, deep peroneal, superficial peroneal branches, saphenous, sural) in the ankle and foot was developed.
• Bupivacaine 0.5% (Marcaine) was used as the long-acting anesthetic agent.
• A pneumatic tourniquet was employed in conjunction with the nerve block for surgical procedures.

Main Results:

• The nerve block technique was effective for performing mid and forefoot surgery on both inpatient and outpatient bases.
• Analgesia lasted between 10 to 25 hours, significantly reducing the need for postoperative analgesics.
• No adverse central nervous system or myocardial reactions were reported, indicating a favorable safety profile.

Conclusions:

• The described peripheral nerve block method is a simplified, predictable, and safe approach for ankle and foot surgery.
• This technique effectively alleviates the risks associated with general or spinal anesthesia.
• The long duration of analgesia provides excellent pain control post-operatively.