Continuous Popliteal Block for Postoperative Analgesia in Total Ankle Arthroplasty

Background: Total ankle arthroplasty is associated with severe postoperative pain. Development of analgesic techniques such as a block with continuous infusion at the popliteal level has been shown to result in good pain control, a decrease in the use of rescue analgesia and a low rate of complicati...

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Bibliographic Details
Published in:Foot & ankle international 2012-03, Vol.33 (3), p.208-212
Main Authors: Gallardo, Jorge, Lagos, Leonardo, Bastias, Christian, Henríquez, Hugo, Carcuro, Giovanni, Paleo, Marcos
Format: Article
Language:English
Subjects:
Analgesics, Opioid - therapeutic use
Anesthetics, Local - administration & dosage
Arthroplasty, Replacement, Ankle
Bupivacaine - administration & dosage
Humans
Infusions, Intravenous
Morphine - therapeutic use
Nerve Block - methods
Pain Measurement
Pain, Postoperative - prevention & control
Patient Satisfaction
Prospective Studies
Sciatic Nerve
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Summary:Background: Total ankle arthroplasty is associated with severe postoperative pain. Development of analgesic techniques such as a block with continuous infusion at the popliteal level has been shown to result in good pain control, a decrease in the use of rescue analgesia and a low rate of complications. We reviewed our experience with this method of analgesia in patients who underwent total ankle arthroplasty. Methods: A prospective study of 30 patients undergoing total ankle arthroplasty was carried out. Twenty-two of these received and maintained a block at the popliteal level with a continuous infusion of bupivacaine, while the remaining eight received no such block. Results: The visual analog scale evaluation (VAS) showed a significant improvement in pain control in the group with the popliteal block after 6, 12, 18, and 24 hours postsurgery, with pain levels peaking and being most different between 6 and 12 hours postsurgery for the two groups. The group with the popliteal block also exhibited a significantly lower consumption of morphine and a greater degree of patient satisfaction. Conclusion: The block with continuous infusion at the popliteal fossa was a safe technique for total ankle arthroplasty postoperative analgesia, which provided good pain control, a lower requirement of opiates and a higher level of patient satisfaction. Level of Evidence: II; Prospective Comparative Study
ISSN:1071-1007
1944-7876
DOI:10.3113/FAI.2012.0208