Impact Of Nerve Blocks On Postoperative Pain And Suffering In Forefoot Bony Surgery – Case Series Of 43 Patients

Research Article
Rajitha Gunaratne G D., Sarah Liew., Andrej Nikoloski and Krishna Boddu
DOI: 
http://dx.doi.org/10.24327/ijrsr.2017.0804.0192
Subject: 
science
KeyWords: 
Forefoot, Blocks, Pain, Surgical delay, Foot and ankle, Suffering
Abstract: 

Background: Nerve blocks are commonly used in Orthopaedic forefoot surgeries to provide safe, effective and long-acting analgesia. There are several types of nerve block commonly utilised in clinical practice; including ankle blocks, saphenous nerve blocks, sciatic nerve blocks, and popliteal blocks. However, depending on the chosen technique, varying degrees of surgical delay can be expected considering the need for separate anaesthetic setupsorpatient repositioning. Also, outcomes such as time to postoperative ambulation can vary depending on the use of ankle versus more proximal nerve blocks given the muscle groups affected. Despite these varying outcomes, few studies have compared the efficacy of various blocks on controlling post-operative pain.

Method: 43 patients who underwent elective forefoot surgery under different nerve blocks (sciatic, saphenous and sciatic, and ankle) were contacted post-operatively to assess their level of self-reported pain and suffering.

Results: There was no significant differences between the three nerve block types on the survey outcomes of interest: suffering (χ 2 (2) = .49, p = 0.78) and pain (χ 2 (2) = .89, p = 0.64).

Conclusion: The use of ankle blocks in forefoot surgery provides equally effective analgesia when compared to more proximal blocks. This supports the use of ankle blocks, which can increase theatre efficiency and early ambulation for patients. This in turn decreases operating costs.