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
Copyright © 2020 by The American Society for BioMedicine and BM-Publisher, Inc.
- Weledji EP, Fokam P. Treatment of the diabetic foot–to amputate or not? BMC surgery 2014;14(1):83.
https://doi.org/10.1186/1471-2482-14-83
PMid:25344293 PMCid:PMC4218993 - Jarrett P. Day care surgery. European Journal of Anaesthesiology. 2001;18(S23):32-35.
https://doi.org/10.1097/00003643-200111001-00007
https://doi.org/10.1097/00003643-200100003-00007
https://doi.org/10.1046/j.1365-2346.2001.00007.x - McQuay H, Carroll D, Moore R. Postoperative orthopaedic pain-the effect of opiate premedication and local anaesthetic blocks. Pain 1988;33(3):291-295.
https://doi.org/10.1016/0304-3959(88)90287-4 - Needoff M, Radford P, Costigan P. Local anesthesia for postoperative pain relief after foot surgery: a prospective clinical trial. Foot & ankle international 1995;16(1):11-13.
https://doi.org/10.1177/107110079501600103
PMid:7697147 - Rongstad K, Mann RA, Prieskom D, Nichelson S, Horton G. Popliteal sciatic nerve block for postoperative analgesia. Foot & ankle international. 1996;17(7):378-382.
https://doi.org/10.1177/107110079601700704
PMid:8832243 - Sharrock N, WALLER JR J, Fierro L. Midtarsal block for surgery of the forefoot. BJA: British Journal of Anaesthesia 1986;58(1):37-40.
https://doi.org/10.1093/bja/58.1.37
PMid:3942668 - Hansen E, Eshelman MR, Cracchiolo III A. Popliteal fossa neural blockade as the sole anesthetic technique for outpatient foot and ankle surgery. Foot & ankle international 2000;21(1):38-44.
https://doi.org/10.1177/107110070002100107
PMid:10710260 - Schipper ON, Hunt KJ, Anderson RB, Davis WH, Jones CP, Cohen BE. Ankle Block vs Single-Shot Popliteal Fossa Block as Primary Anesthesia for Forefoot Operative Procedures: Prospective, Randomized Comparison. Foot & ankle international 2017;38(11):1188-1191.
https://doi.org/10.1177/1071100717723132
PMid:28814096 - Urfalioglu A, Gokdemir O, Hanbeyoglu O, et al. A comparison of ankle block and spinal anesthesia for foot surgery. International journal of clinical and experimental medicine 2015;8(10):19388-19393.
PMid:26770580 PMCid:PMC4694480 - Casati A, Fanelli G, Borghi B, Torri G. Ropivacaine or 2% mepivacaine for lower limb peripheral nerve blocks. Anesthesiology: The Journal of the American Society of Anesthesiologists 1999;90(4):1047-1052.
https://doi.org/10.1097/00000542-199904000-00018
PMid:10201676 - Hajek V, Dussart C, Klack F, et al. Neuropathic complications after 157 procedures of continuous popliteal nerve block for hallux valgus surgery. A retrospective study. Orthopaedics & Traumatology: Surgery & Research. 2012;98(3):327-333.
https://doi.org/10.1016/j.otsr.2011.11.004
PMid:22459100 - Davies AR, Ware Jr JE. Involving consumers in quality of care assessment. Health affairs 1988;7(1):33-48.
https://doi.org/10.1377/hlthaff.7.1.33 - Canales M, Huntley H, Reiner M, Ehredt D, Razzante M. The popliteal nerve block in foot and ankle surgery: an efficient and anatomical technique. J Anesth Clin Res 2015;6(553):2.
https://doi.org/10.4172/2155-6148.1000553 - Hegewald K, McCann K, Elizaga A, Hutchinson BL. Popliteal blocks for foot and ankle surgery: success rate and contributing factors. The Journal of Foot and Ankle Surgery 2014;53(2):176-178.
https://doi.org/10.1053/j.jfas.2013.04.008
PMid:23747220 - Anderson JG, Bohay DR, Maskill JD, et al. Complications after popliteal block for foot and ankle surgery. Foot & ankle international 2015;36(10):1138-1143.
https://doi.org/10.1177/1071100715589741
PMid:26109605 - Capuzzo M, Alvisi R. Is it possible to measure and improve patient satisfaction with anesthesia? Anesthesiology clinics 2008;26(4):613-626.
https://doi.org/10.1016/j.anclin.2008.07.008
PMid:19041619 - Fung D, Cohen MM. Measuring patient satisfaction with anesthesia care: a review of current methodology. Anesthesia & Analgesia 1998;87(5):1089-1098
https://doi.org/10.1213/00000539-199811000-00020
https://doi.org/10.1097/00000539-199811000-00020
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Research Article
DOI: http://dx.doi.org/10.18081/2333-5106/019-1/13-23
American Journal of BioMedicine Volume 8, Issue 4, pages 235-245
Received June 30, 2020; Accepted September 25, 2020; Published October 23, 2020