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CONTROLLED RANDOMIZED TRIAL OF A POPLITEAL BLOCK FOR PAIN RELIEF IN ANKLE AND HINDFOOT SURGERY



Abstract

Introduction: We present the results of a controlled randomized trial of the use of a popliteal block for pain relief in ankle and hindfoot surgery.

Materials and methods: We studied 47 patients over period of nine months in 2007 to 2008. Patients undergoing an ankle or hindfoot procedure were included in the trial. The trial was explained to the patients. Written information leaflets were also used in the preoperative clinics. Patients were randomized on the day of surgery. A sealed envelope randomizing the patient to block (A), or no block (B) was opened in the anaesthetic room before the patient was anaesthetised. Patients were subjective pain scores were recorded at 30 min, 6, 12 and 24 hours after surgery. The amount of analgesia required and time to first dose was documented. One foot and ankle consultant and one trained fellow gave the popliteal blocks. The block was administered in the lateral position at 0.8 mAmp stimulus to detect the nerve. Group A and B data was compared statistically.

Results: The average pain scores in group A were reported to be 1.2 at 30min, 1.23 at 6, 2.1 at 12 and 3 at 24 hours. In group B it was 1.2 at 30min, 7.2, 8.1 and 4 at 6, 12 and 24 hours. There was a statistical significant difference in the pain scores at 6 and 12 hours. There was no statistical significant difference in the pain scores at 30 min and 24 hours.

Conclusion: Popliteal block gives effective pain relief in ankle and hindfoot surgery. We believe that it may reduce anaesthetic and analgesic drug requirement as well.

Correspondence should be addressed to A.H.N. Robinson, BOX 37, Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge. CB2 0QQ, England.