title: Safety and efficacy of the popliteal fossa nerve block when utilized for foot and ankle surgery.
abstract: The popliteal fossa nerve block (PFNB) offers numerous advantages that make it a suitable anesthetic technique for foot and ankle surgery. In this retrospective study, we investigated the acute and long-term safety and efficacy of this relatively underutilized anesthetic technique for foot and ankle surgery. A review of 834 patients who underwent foot and/or ankle surgery by the coauthor (NAA) was conducted. Four hundred sixty-seven patients received a PFNB with the aid of a peripheral nerve stimulator. Variables assessed included the quality of surgical anesthesia, postoperative analgesia and the acute and long-term incidence of postoperative neuralgia and neuropraxia. The PFNBs were performed by anesthesiologists with various levels of training at a tertiary care hospital and all were supplemented with a saphenous nerve block. The PFNB was successful as the sole anesthetic technique in 79% of the cases; 18% were converted to general anesthesia and 3% required augmentation with local anesthetic. There were no complications associated with the PFNB. There were no incidents of postoperative neuralgia or neuropraxia. Only 12% of patients with a successful block required analgesics in the PACU, while 60% of patients with a failed block required systemic analgesics for surgical site pain (p<0.01). These results suggest that the performance of the PFNB with the guidance of a peripheral nerve stimulator is a safe and effective anesthetic technique for foot and ankle surgery.
authors.affiliation: Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Provenzano
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Viscusi
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Adams
authors.forename: Michael B
authors.initials: MB
authors.lastname: Kerner
authors.forename: Marc C
authors.initials: MC
authors.lastname: Torjman
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Abidi
mesh_terms: D000842:Ankle / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain; D012189:Retrospective Studies