Background: Popliteal sciatic nerve blockade is a commonly used technique employed in the management of postoperative pain following foot and ankle surgery. Recent studies have shown that for outpatient surgery, for moderately painful procedures, a continuous infusion of local anesthesia via an indwelling catheter for 48 to 72 hours leads to reduced opiate analgesic requirements and improved pain and patient satisfaction scores. Materials and Methods: A prospective, randomized, double blind, placebo-controlled trial of a continuous infusion of bupivacaine verses normal saline via a popliteal catheter after a single bolus popliteal block for 72 hours after major ankle and hind foot surgery was performed in 54 patients. Results: The average pain scores overall were low (range, 1.1 to 3.6 on a Visual Analogue Scale of 0 to 10) throughout the study period. Statistically significantly lower pain scores with significantly less requirement for supplementary opiate analgesic agents were seen in the treatment group. Conclusion: Despite the statistically significant findings, with such low pain scores in both groups, we believe it remains debatable whether the extra time and cost involved warrants the use of a continuous popliteal blockade over a single bolus injection.
Level of Evidence: I, Prospective, Randomized, Controlled Trial
. FuzierRCuvillonPDelcourtJ: [Peripheral nerve block in orthopaedic surgery: multicentric evaluation of practicing professionals and impact on the activity of the recovery room]. Ann Fr Anesth Reanim.26:761–768, 2007. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.annfar.2007.07.001.
8.
. IlfeldBMLolandVJGerancherJC: The effects of varying local anesthetic concentration and volume on continuous popliteal sciatic nerve blocks: a dual-center, randomized, controlled study. Anesth Analg.107:701–707, 2008. https://dx-doi-org.web.bisu.edu.cn/10.1213/ane.0b013e3181770eda.
. JarrettGJRongstadKMSnyderM: Technique tip: popliteal nerve block by surgeon in the lateral decubitus position. Foot Ankle Int.25:37–38, 2004.
12.
. KleinSMPietrobonRNielsenKC: Peripheral nerve blockade with long-acting local anesthetics: a survey of the Society for Ambulatory Anesthesia. Anesth Analg.94:71–76, table of contents, 2002.
13.
. LealENRibeiroJLOliveiraMMRoquetteJ: Psychosocial aspects associated with pain perception in individuals undergoing coronary surgery. Rev Port Cardiol.24:1221–1231, 2005.
14.
. LoggiaMLSchweinhardtPVillemureCBushnellMC: Effects of psychological state on pain perception in the dental environment. J Can Dent Assoc.74:651–656, 2008.
15.
. McLeodDHWongDHClaridgeRJMerrickPM: Lateral popliteal sciatic nerve block compared with subcutaneous infiltration for analgesia following foot surgery. Can J Anaesth.41:673–676, 1994. https://dx-doi-org.web.bisu.edu.cn/10.1007/BF03015619.
16.
. McLeodDHWongDHVaghadiaH: Lateral popliteal sciatic nerve block compared with ankle block for analgesia following foot surgery. Can J Anaesth.42:765–769, 1995. https://dx-doi-org.web.bisu.edu.cn/10.1007/BF03011173.
. PerlasABrullRChanVW: Ultrasound guidance improves the success of sciatic nerve block at the popliteal fossa. Reg Anesth Pain Med.33:259–265, 2008.
21.
. ProvenzanoDAViscusiERAdamsSBJr.: Safety and efficacy of the popliteal fossa nerve block when utilized for foot and ankle surgery. Foot Ankle Int.23:394–399, 2002.
