Foot is one of the most parts of the body that faces many problems such as trauma, strain, infection and other pathological conditions. Diabetes Mellitus is a multi-systemic disease that effects most organs. This prospective study aimed to compare the effectiveness of five nerves ankle block versus popliteal sciatic with adductor canal saphenous block in diabetic foot surgery. Hundred patients were included in this study (American Society of Anesthesiologists class III and IV-E). All the participants had full routine preoperative investigations with doppler ultrasound study for peripheral circulation. Two groups, group A involves those who had operation under ankle block regional anesthesia, while group B, anesthesia was done by popliteal sciatic–saphenous adductor canal block. There was a significant difference between the two anesthetic techniques regarding the onset of action and efficiency of 0.75% ropivacaine in popliteal sciatic nerve block in comparison with five nerves ankle block. Almost all the patients and surgeons were satisfied by popliteal sciatic-saphenous adductor canal block in which there was minimal need of sedative and analgesic drugs such as midazolam or ketamine. Popliteal sciatic–adductor canal saphenous block is more convenient and effective to provide the state of surgical anesthesia with minimal need to adjuvant sedative drugs. The best results could be obtained with the popliteal sciatic-saphenous block with only 2 injections instead of 5. This will minimize the risk of infection as it is far from the operative site. Also, it is faster in onset of action and provides good postoperative analgesia than ankle block.
Keywords: Ultrasound guided; Popliteal sciatic-saphenous block; Ropivacaine
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