title: Perioperative analgesia: a factor in the development of heel pressure ulcers?
abstract: This article presents the incidence of heel pressure ulcers after an elective hip or a knee replacement. The majority of patients in the authors' institute receive either a neuraxial block (epidural and/or spinal) or peripheral nerve blocks (femoral and sciatic), depending on the anaesthetist's and surgeon's preference, and the patient's physical status. The past few years have seen increasing use of peripheral nerve blocks for knee replacement surgery. Patients with either the central or peripheral nerve blockade are at an increased risk of developing heel pressure ulcers. This article describes the experience at a tertiary referral centre and, in particular, highlights the risk of developing heel ulcers in patients receiving peripheral nerve blocks. Medical and nursing staff looking after these patients should be made aware of this complication and appropriate measures should be taken to prevent this avoidable complication.
authors.affiliation: University of Oxford, UK.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Edwards
authors.forename: Hemant
authors.initials: H
authors.lastname: Pandit
authors.forename: Mansukh T
authors.initials: MT
authors.lastname: Popat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000706:statistics & numerical data; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006365:Heel; D006782:Hospitals, Special; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects* / Q000706:statistics & numerical data; D009720:Nurse Clinicians; D009730:Nursing Assessment; D009985:Orthopedics; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care / Q000451:nursing; D003668:Pressure Ulcer / Q000145:classification / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D012308:Risk Management; D012720:Severity of Illness Index; D014945:Wound Healing