Background and Aim Surgery for malleolar fractures is associated with severe pain. Ultrasonography-guided nerve blocks have quality, precision, and drug dose reduction but are not preferred over spinal anesthesia. We have conducted a study to compare the effectiveness of femoropopliteal block with spinal anesthesia. Objective The aim of this study was to compare onset, duration, and hemodynamic variability and total analgesic requirement of femoropopliteal block with spinal anesthesia. Methods Preoperatively patients were divided into two groups (30 in each): Group 1—patients receiving spinal anesthesia with 0.5% hyperbaric bupivacaine; Group 2—patients receiving 15 mL in popliteal block and 5 mL in femoral block of 20 mL 0.5% bupivacaine with 8 mg dexamethasone. Onset, duration, hemodynamic changes, and postoperative analgesia requirements were monitored. Results Mean onset of sensory blockade in group 1 and 2 was 3.83 ± 0.92 and 12.68 ± 3.03 minutes (p-value <0.001.) and motor blockade in group 1 and 2 was 5.36 ± 1.7 and 12.68 ± 3.03 minutes (p-value <0.01), respectively. Mean duration of analgesia in group 1 and 2 was 3 ± 1.31 and 20.2 ± 4.7 hours, respectively. None of the patients in group 2 and 3% in group 1 had hypotension and bradycardia (p-value > 0.05). The mean dose of morphine required in group 1 and 2 was 20.3 ± 2.1 and 3.56 ± 0.02 mg in 24 hours (p-value < 0.001), respectively. Conclusion Femoropopliteal block was slower in onset but produced longer postoperative analgesia with markedly reduced opioid consumption.

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