Supramalleolar Ankle Block for Foot and Ankle Surgery
Article Sidebar
Main Article Content
Abstract
Materials and Methods: We performed a retrospective observational study of the past 5 years of patients with foot and ankle pathology that had undergone the supramalleolar ankle block. We excluded patients with a history of previous foot surgery, bilateral surgeries, vascular disease, peripheral neuropathy, diabetes, smoking, or active surgical site infection. The supramalleolar ankle block was guided by anatomic landmarks and we used a solution of lidocaine 2% and bupivacaine 0.5%. We evaluated the duration of the ankle block, the visual analog scale (VAS) for pain 24 hrs after surgery, the time until the first analgesic dose, and the level of patient satisfaction.
Results: 771 patients were included in this study, all of whom had complete analgesia for at least 12 hrs (mean 18 hrs) after surgery. The mean value on the VAS for pain after 24 hrs was 1.4. On average, the first analgesic dose was administered 16 hrs after surgery. The level of satisfaction about the pain perceived in the first 24 hrs after surgery was: very satisfied (89%), satisfied (10%), and dissatisfied (1%). There were no reports of permanent neurological sequelae, systemic toxicity, or surgical site infections.
Conclusion: We consider the supramalleolar ankle block a simple, effective, and safe procedureto obtain long-lasting postoperative analgesia.
Downloads
Metrics
Article Details
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
2. Fraser TW, Doty JF. Peripheral nerve blocks in foot and ankle surgery. Orthop Clin North Am 2017;48(4):507-15.
https://doi.org/10.1016/j.ocl.2017.06.008
3. Monkowski D, Egidi H. Bloqueo de tobillo. Rev Arg Anest 2004;62(6):513-7. Disponible en:
https://www.anestesia.org.ar/search/articulos_completos/1/1/817/c.pdf
4. Myerson MS, Ruland CM, Allon SM. Regional anesthesia for foot and ankle surgery. Foot Ankle 1992;13(5):282-8. https://doi.org/10.1177/107110079201300510
5. Sarrafian SK, Ibrahim IN, Breihan JH. Ankle-foot peripheral nerve block for mid and forefoot surgery. Foot Ankle 1983;4(2):86-90. https://doi.org/10.1177/107110078300400209
6. Shah S, Tsai T, Iwata T, Hadzic A. Outpatient regional anesthesia for foot and ankle surgery. Int Anesthesiol Clin
2005;43:143-51. https://doi.org/10.1097/01.aia.0000166331.15886.2e
7. Mentzel M, Fleischmann W, Bauer G, Kinzl L. Ankle joint denervation. Part 1: Anatomy - The sensory innervation of the ankle joint. Foot Ankle Surg 1999;5(1):15-20. https://doi.org/10.1046/j.1460-9584.1999.51121.x
8. Williams PL (ed.). Anatomía de Gray, 38ª ed. Madrid. Harcourt Brace; 1998.
9. Kelikian AS, Sarrafian SK. Sarrafian’s Anatomy of the foot and ankle: Descriptive, topographic, functional, 3rd ed. Philadlephia: Lippincott Williams & Wilkins; 2011.
10. Reddi D, Curran N. Chronic pain after surgery: pathophysiology, risk factors and prevention. Postgrad Med J
2014;90(1062):222-7. https://doi.org/10.1136/postgradmedj-2013-132215
11. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet
2006;367(9522):1618-25. https://doi.org/10.1016/S0140-6736(06)68700-X
12. Howell R, Hill B, Hoffman C, Treacy E, Mulcahey MK. Peripheral nerve blocks for surgery about the knee. JBJS
Rev 2016;4(12):e1. https://doi.org/10.2106/JBJS.RVW.16.00003
13. Florez J. Farmacología humana, 6ª ed. España: Elsevier Masson; 2014.
14. Brunton LL, Chabner B, Knollman B (eds.). Goodman & Gilman - Las bases farmacológicas de la terapéutica, 12ª ed. Philadelphia: McGraw-Hill Interamericana Editores; 2012.