Peripheral Foot Blockade Versus Popliteal Fossa Nerve Block: A Prospective Randomized Trial in 51 Patients

Efficacy of Popliteal Block in Postoperative Pain Control After Ankle Fracture Fixation

“…This data is similar to that reported in previous studies. [11][12][13][14][15][16][17] However, our study patients who receive a popliteal block experience a dramatic increase in their pain between eight and twenty-fours, while patients who received general anesthesia alone experience a steady decrease in their pain over time after surgery. This finding was unique to our study and was an important one in understanding post-operative pain management.…”

“…Previous studies documenting the efficacy of popliteal blocks describe its use with perineural catheters or do not follow patients after the block has stopped working. [11][12][13][14][15][16][17] We think that the phenomenon of rebound pain can be minimized with the timely use of oral narcotics. Preoperatively, patients need to be counseled to begin taking oral pain medication 1-2 hours before the regional anesthesia ceases to work.…”

“…Previous work investigating the use of regional anesthesia in the upper and lower extremity has found that regional anesthesia can be associated with both decreased postoperative narcotic use and decreased time to discharge. [2][3][4][5][6][7] Regional blocks for elective shoulder [8][9][10] and foot and ankle surgery [11][12][13][14][15][16][17] have been found to be effective alternatives to general endotracheal anesthesia. The efficacy of regional blocks, including spinal anesthesia, femoral nerve blocks, and popliteal blocks, in ameliorating immediate postoperative pain has also been described for a wide variety of lower extremity procedures, including hip fractures, 18,19 total knee arthroplasty, 20 anterior cruciate ligament reconstruction, 21 and calcaneus fractures.…”

“…Previous studies have found success rates with popliteal regional block anesthesia ranging from 79% to more than 97%. [11][12][13][14][15][16][17] The duration of postoperative analgesia is significantly longer in patients who received a popliteal block as compared to those who received spinal anesthesia. 24 These findings suggest that the use of a localized popliteal block affords the patient potential for decreased postoperative narcotic use and improved pain control over that which both general and spinal anesthesia can offer.…”

“…24 These findings suggest that the use of a localized popliteal block affords the patient potential for decreased postoperative narcotic use and improved pain control over that which both general and spinal anesthesia can offer. Despite the plethora of studies suggesting the efficacy of regional anethesia in fracture fixation, 18,19,22 and of popliteal blocks for foot and ankle surgery, [11][12][13][14][15][16][17] no studies to date have addressed the use of this technique for operative fixation of ankle fractures. To the best of our knowledge, there has been no published literature investigating the possible use of a regional block and more specifically, a popliteal block, for the purposes of ameliorating postoperative pain following ankle fracture fixation.…”