Femoral and sciatic nerve block for hindfoot and ankle surgery

Lee, Kyung Tai; Park, Young Uk; Jegal, Hyuk; Roh, Young Tae; Kim, Jin Su; Yoon, Ji Sang

doi:10.1007/s00776-014-0576-5

Cited by 23 publications

(25 citation statements)

References 21 publications

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“…The observed improved analgesia is similar to the report of complete absence of pain in 77% of patients receiving saphenous nerve blockade for lower extremity surgery [22]. Combined sciatic and femoral nerve blockade has been observed to produce slightly lower analgesic efficacy compared to sciatic nerve blockade alone for lower extremity surgery however targeted blockade of the saphenous component of the femoral nerve and its influence on postoperative pain control were not evaluated [23]. The lower intraoperative opioid dosages administered to opioid naïve females could account for the differences noted in the lower pain scores and immediate postoperative rescue analgesic opioid dosages for opioid naïve males.…”

Section: Discussionsupporting

confidence: 69%

Combined Saphenous-Sciatic Nerve Blockade Superior to Femoral-Sciatic Nerve Blockade for Postoperative Analgesia Following Foot and Ankle Surgery

2015

JACCOA

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Section: Discussionsupporting

confidence: 69%

Combined Saphenous-Sciatic Nerve Blockade Superior to Femoral-Sciatic Nerve Blockade for Postoperative Analgesia Following Foot and Ankle Surgery

2015

JACCOA

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“…The sample size determination was based on a recently completed trial [3] at our institution evaluating anesthetic and analgesic effects of sciatic and FNBs in the hindfoot and ankle surgeries involving the medial side of ankle. We chose a noninferior design to demonstrate that ACB was not inferior to FNB as an anesthetic and analgesic technique while demonstrating the superiority of preservation of quadriceps motor strength after ACB compared to FNB.…”

Section: Discussionmentioning

confidence: 99%

“…The use of this type of anesthesia is supported by successful outcomes reported in the literature. [3–5] Ankle block and sciatic nerve block (SNB) are 2 of the most popular anesthetic techniques used in foot and ankle surgery. Both have been shown to be safe and effective for these surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a study showed that femoral nerve block (FNB) provides good surgical anesthesia and good postoperative pain control for patients with hindfoot and ankle conditions. [3] However, FNB leads to femoral quadriceps muscle weakness. [14,15] Consequently, quadriceps weakness results in functional impairment and it is associated with an increased risk of postoperative falls.…”

Section: Introductionmentioning

confidence: 99%

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Adductor canal block versus femoral nerve block combined with sciatic nerve block as an anesthetic technique for hindfoot and ankle surgery

Joe

Choo²,

Yoon³

et al. 2016

Medicine

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Background:A femoral nerve block (FNB) in combination with a sciatic nerve block (SNB) is commonly used for anesthesia and analgesia in patients undergoing hindfoot and ankle surgery. The effects of FNB on motor function, related fall risk, and rehabilitation are controversial. An adductor canal block (ACB) potentially spares motor fibers in the femoral nerve, but the comparative effect on hindfoot and ankle surgeries between the 2 approaches is not yet well defined. We hypothesized that compared to FNB, ACB would cause less weakness in the quadriceps and produce similar pain scores during and after the operation.Methods:Sixty patients scheduled for hindfoot and ankle surgeries (arthroscopy, Achilles tendon surgery, or medial ankle surgery) were stratified randomized for each surgery to receive an FNB (FNB group) or an ACB (ACB group) combined with an SNB. The primary outcome was the visual analog scale (VAS) pain score at each stage. Secondary outcomes included quadriceps strength, time profiles (duration of the block procedure, time to full anesthesia and time to full recovery), patients’ analgesic requirements, satisfaction, and complications related to peripheral nerve blocks such as falls, neurologic symptoms, and local anesthetic systemic toxicity were evaluated. The primary outcome was tested for the noninferiority of ACB to FNB, and the other outcomes were tested for the superiority of each variable between the groups.Results:A total of 31 patients received an ACB and 29 received an FNB. The VAS pain scores of the ACB group were not inferior during and after the operation compared to those of the FNB group. At 30 minutes and 2 hours after anesthesia, patients who received an ACB had significantly higher average dynamometer readings than those who received a FNB (34.2 ± 20.4 and 30.4 ± 23.7 vs 1.7 ± 3.7 and 2.3 ± 7.4, respectively), and the results were similar at 24 and 48 hours after anesthesia. There were no differences between the 2 groups with regard to time profiles and patient satisfaction. No complications were noted.Conclusion:ACB preserved quadriceps muscle strength better than FNB, without a significant difference in postoperative pain. Therefore, ACB may be a good alternative to FNB for reducing the potential fall risk.

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“…From 1994 to 2006, an increase occurred in the number of procedures performed using regional blocks (range 3.3% to 10.1%). Compared with general anesthesia, peripheral nerve blocks are a safe and cost-effective method of pain control for foot and ankle surgery (54,55).…”

Section: Discussionmentioning

confidence: 99%

National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey

Buller

Miranda

2015

The Journal of Foot and Ankle Surgery

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Femoral and sciatic nerve block for hindfoot and ankle surgery

Cited by 23 publications

References 21 publications

Combined Saphenous-Sciatic Nerve Blockade Superior to Femoral-Sciatic Nerve Blockade for Postoperative Analgesia Following Foot and Ankle Surgery

Combined Saphenous-Sciatic Nerve Blockade Superior to Femoral-Sciatic Nerve Blockade for Postoperative Analgesia Following Foot and Ankle Surgery

Adductor canal block versus femoral nerve block combined with sciatic nerve block as an anesthetic technique for hindfoot and ankle surgery

National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey

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